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General NPI Number Information
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NPI Number | 1316834062
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Entity Type | Organization
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Legal Business Name | LENSHOP MARIEL COLON MBR
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | BO SUMIDERO CARR 173 KM 18 5
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City | AGUAS BUENAS
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State | PR
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Zip | 00703
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Country | US
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Telephone | 787-371-6437
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 149
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City | AGUAS BUENAS
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State | PR
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Zip | 00703-0149
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Country | US
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Telephone | 787-371-6437
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | MARIEL COLON
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Credential |
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Telephone | 787-371-6437
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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 |
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License Number State |
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