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General NPI Number Information
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NPI Number | 1679863765
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Entity Type | Organization
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Legal Business Name | I DESIGNS
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | ASHFORD MEDICAL CENTER SUITE 707 CALLE WASHINGTON #29
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City | SAN JUAN
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State | PR
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Zip | 00907-1503
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Country | US
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Telephone | 787-746-9290
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Fax |
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Provider Business Mailing Address
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Address Line | MUNOZ RIVERA #9 C-2
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-746-9290
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Fax | 787-744-2860
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Authorized Official
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Title or Position | OPTOMETRIST / PRESIDENT
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Name | DR. VIVIANNE GARCIA
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Credential | O.D.
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Telephone | 787-746-9290
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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 | 668
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 607
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License Number State | PR
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