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General NPI Number Information
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NPI Number | 1366748337
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Entity Type | Organization
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Legal Business Name | NEW OPTICAL
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | URB. SIERRA BAYAMON 7-13 NORTH MAIN STE.1
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City | BAYAMON
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State | PR
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Zip | 00961-4326
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Country | US
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Telephone | 787-785-3374
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Fax | 787-785-3374
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Provider Business Mailing Address
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Address Line | 243 CALLE RIO CIBUCO URB.MONTE CASINO HEIGHTS
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City | TOA ALTA
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State | PR
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Zip | 00953-3761
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Country | US
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Telephone | 787-785-3374
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Fax | 787-785-3374
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Authorized Official
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Title or Position | OWNER
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Name | IDA OTERO
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Credential |
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Telephone | 787-785-3374
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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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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 332H00000X
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License Number State | PR
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