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General NPI Number Information
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NPI Number | 1326312703
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Entity Type | Organization
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Legal Business Name | PONCE OPTICS CARE, INC
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Dates
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Enumeration Date | 03/01/2012
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Last Update Date | 03/01/2012
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Provider Practice Location Address
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Address Line | 108 CALLE ATOCHA
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City | PONCE
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State | PR
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Zip | 00730-3772
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Country | US
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Telephone | 787-844-2295
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Fax | 787-844-2295
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Provider Business Mailing Address
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Address Line | 108 CALLE ATOCHA
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City | PONCE
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State | PR
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Zip | 00730-3772
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Country | US
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Telephone | 787-844-2295
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Fax | 787-844-2295
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | ANGELITA MARTINEZ
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Credential |
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Telephone | 787-568-6896
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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 | 704
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License Number State | PR
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