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General NPI Number Information
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NPI Number | 1124455977
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Entity Type | Organization
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Legal Business Name | MIGUEL RESTO MEJIAS
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Dates
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Enumeration Date | 10/10/2013
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Last Update Date | 10/10/2013
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Provider Practice Location Address
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Address Line | HC 1 BOX 26912
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City | CAGUAS
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State | PR
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Zip | 00725-8933
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Country | US
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Telephone | 787-484-2640
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 26912
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City | CAGUAS
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State | PR
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Zip | 00725-8933
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Country | US
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Telephone | 787-484-2640
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Fax |
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. MIGUEL RESTO MEJIAS
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Credential | OPTICIAN
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Telephone | 787-484-2640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 326
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License Number State | PR
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