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General NPI Number Information
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NPI Number | 1508186602
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Entity Type | Organization
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Legal Business Name | EYE MEDICAL CENTER
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 06/11/2010
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Provider Practice Location Address
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Address Line | CARR. 198 KM 19.4 OLYMPIC SHOPPING COURT CENTER
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City | LAS PIEDRAS
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State | PR
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Zip | 00771
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Country | US
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Telephone | 787-716-4666
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Fax | 787-716-4666
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Provider Business Mailing Address
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Address Line | PO BOX 46
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City | HUMACAO
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State | PR
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Zip | 00792
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Country | US
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Telephone | 787-716-4666
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Fax | 787-716-4666
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Authorized Official
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Title or Position | PROPIETARIO
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Name | MR. HECTOR J PABON DEL RIO
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Credential |
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Telephone | 787-716-4666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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