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General NPI Number Information
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NPI Number | 1659715720
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Entity Type | Organization
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Legal Business Name | OPTICA L.M. , INC.
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Dates
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Enumeration Date | 04/19/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | CARR 863 KM 1.2 BO PAJAROS
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-798-0575
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Fax | 787-798-0575
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Provider Business Mailing Address
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Address Line | PO BOX 703
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City | TOA BAJA
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State | PR
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Zip | 00951-0703
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Country | US
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Telephone | 787-798-0575
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Fax | 787-798-0575
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Authorized Official
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Title or Position | PRESIDENT
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Name | CAROL MALDONADO
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Credential |
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Telephone | 787-798-0575
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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 | 609
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | PR
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