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General NPI Number Information
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NPI Number | 1487866166
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Entity Type | Organization
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Legal Business Name | EYE EXPRESS 20-20
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | EYE EXPRESS 20-20, PLAZA RIAL, HWY 185, KM .9
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City | CANOVANAS
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State | PR
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Zip | 00729
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Country | US
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Telephone | 787-876-5511
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Fax | 787-876-5511
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Provider Business Mailing Address
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Address Line | PO BOX 938
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City | CANOVANAS
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State | PR
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Zip | 00729-0938
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Country | US
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Telephone | 787-876-5511
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CARMEN GLADYS GARCIA
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Credential |
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Telephone | 787-876-5511
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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 | 167
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License Number State | PR
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