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General NPI Number Information
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NPI Number | 1235471459
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Entity Type | Organization
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Legal Business Name | MELISSA OPTICA
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | #41 CALLE DR. BARRERA
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City | JUNCOS
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State | PR
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Zip | 00777
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Country | US
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Telephone | 787-734-3303
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Fax |
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Provider Business Mailing Address
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Address Line | 41 CALLE DR BARRERAS
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City | JUNCOS
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State | PR
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Zip | 00777-3509
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Country | US
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Telephone | 787-734-3303
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Fax |
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Authorized Official
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Title or Position | OPTICIAN
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Name | MS. NELLIE VALENTIN
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Credential | O.L.
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Telephone | 787-734-3303
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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 | 0146
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License Number State | PR
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