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General NPI Number Information
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NPI Number | 1497871735
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Entity Type | Organization
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Legal Business Name | OPTOMETRICS PSC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 02/23/2009
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Provider Practice Location Address
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Address Line | 369 AVE DOMENECH # B
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City | SAN JUAN
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State | PR
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Zip | 00918-3708
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Country | US
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Telephone | 787-754-0814
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Fax | 787-756-5823
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Provider Business Mailing Address
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Address Line | 369 AVE DOMENECH # B
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City | SAN JUAN
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State | PR
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Zip | 00918-3708
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Country | US
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Telephone | 787-754-0814
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Fax | 787-756-5823
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. CARMEN MARIA SUAREZ
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Credential | OD
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Telephone | 787-754-0814
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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 | 193
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License Number State | PR
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