=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598966939
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARCE VISUAL CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/31/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 604 CALLE MUNOZ RIVERA
-----------------------------------------------------
City | PENUELAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00624-1709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-836-1920
-----------------------------------------------------
Fax | 787-836-1920
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 230 CALLE ISABEL MANSION REAL
-----------------------------------------------------
City | COTO LAUREL
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00780-2620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-836-1920
-----------------------------------------------------
Fax | 787-836-1920
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPTOMETRIST -OWNER
-----------------------------------------------------
Name | DR. YOLANDA ARCE
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 787-836-1920
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332H00000X
-----------------------------------------------------
Taxonomy Name | Eyewear Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------