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General NPI Number Information
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NPI Number | 1225306145
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Entity Type | Organization
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Legal Business Name | OPTICA MENDEZ INC. DBA VISTAOPTIC
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 28 CALLE SAN EDMUNDO
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City | SAN JUAN
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State | PR
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Zip | 00927-6437
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Country | US
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Telephone | 787-457-5727
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 367476
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City | SAN JUAN
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State | PR
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Zip | 00936-7476
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Country | US
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Telephone | 787-457-5727
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | PEDRO CUELLAR
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Credential |
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Telephone | 787-457-5727
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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 | 308
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 308
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License Number State | PR
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