=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720241607
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEST VISION LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/09/2008
-----------------------------------------------------
Last Update Date | 05/02/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 410 CALLE MENDEZ VIGO SUITE 201
-----------------------------------------------------
City | DORADO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00646-4800
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-796-4155
-----------------------------------------------------
Fax | 787-796-3746
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 728
-----------------------------------------------------
City | DORADO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00646-0728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-796-4155
-----------------------------------------------------
Fax | 787-796-3746
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. HECTOR M MAYOL III
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 787-796-4155
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 14577
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------