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General NPI Number Information
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NPI Number | 1598982365
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Entity Type | Organization
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Legal Business Name | DR JOSE N LUGO DBA OPTOMETRY WORLD CAROLINA
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 12/30/2011
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Provider Practice Location Address
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Address Line | 10000 AVE 65 INFANTERIA STE 112 CAROLINA SHOPPING COURT
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City | CAROLINA
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State | PR
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Zip | 00985-5638
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Country | US
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Telephone | 787-750-6705
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Fax | 787-762-3212
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Provider Business Mailing Address
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Address Line | 10000 AVE 65 INFANTERIA STE 112 CAROLINA SHOPPING COURT
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City | CAROLINA
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State | PR
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Zip | 00985-5638
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Country | US
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Telephone | 787-750-6705
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Fax | 787-762-3212
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSE N LUGO
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Credential | OD
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Telephone | 787-750-6705
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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 | 153
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License Number State | PR
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