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General NPI Number Information
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NPI Number | 1336595032
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Entity Type | Organization
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Legal Business Name | CIALES VISUAL INC.
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Dates
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Enumeration Date | 05/11/2016
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Last Update Date | 05/11/2016
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Provider Practice Location Address
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Address Line | 51 CALLE JOSE DE DIEGO
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City | CIALES
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State | PR
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Zip | 00638-3228
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Country | US
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Telephone | 787-871-3091
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Fax | 787-871-3091
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Provider Business Mailing Address
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Address Line | 51 CALLE JOSE DE DIEGO
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City | CIALES
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State | PR
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Zip | 00638-3228
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Country | US
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Telephone | 787-871-3091
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Fax | 787-871-3091
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. JOSE E. WHATTS
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Credential | DO
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Telephone | 787-871-3091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 565
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License Number State | PR
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