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General NPI Number Information
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NPI Number | 1245377332
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL OPTICAL CENTER
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | AVE. PRINCIPAL I-18 URB. BARALT
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City | FAJARDO
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State | PR
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Zip | 00738
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Country | US
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Telephone | 787-860-0620
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Fax | 787-860-0620
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Provider Business Mailing Address
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Address Line | AVE. PRINCIPAL I-18 URB. BARALT
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City | FAJARDO
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State | PR
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Zip | 00738
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Country | US
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Telephone | 787-860-0620
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Fax | 787-860-0620
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. SARAHI RODRIGUEZ
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Credential |
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Telephone | 787-860-0620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156F00000X
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Taxonomy Name | Technician/Technologist
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License Number |
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License Number State |
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