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General NPI Number Information
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NPI Number | 1255141594
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Entity Type | Organization
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Legal Business Name | OPTICA DE DIEGO
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 109 CALLE DE DIEGO E
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City | MAYAGUEZ
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State | PR
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Zip | 00680-5499
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Country | US
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Telephone | 787-834-3510
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Fax | 787-834-3510
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Provider Business Mailing Address
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Address Line | 109 CALLE DE DIEGO E
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City | MAYAGUEZ
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State | PR
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Zip | 00680-5499
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Country | US
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Telephone | 787-834-3510
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Fax |
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Authorized Official
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Title or Position | PROPIETARIO
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Name | MR. ANGEL L RUIZ RODRIGUEZ
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Credential | OPTICIAN
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Telephone | 787-834-3510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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