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General NPI Number Information
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NPI Number | 1740965987
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Entity Type | Organization
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Legal Business Name | OPTICA JIREH LLC
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 927 CALLE DURBEC
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City | SAN JUAN
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State | PR
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Zip | 00924-3344
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Country | US
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Telephone | 787-980-0373
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Fax |
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Provider Business Mailing Address
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Address Line | 884 CALLE ZAIDA
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City | SAN JUAN
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State | PR
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Zip | 00924-3308
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Country | US
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Telephone | 787-980-0373
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GLENDA GARCIA
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Credential |
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Telephone | 787-980-0373
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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 |
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License Number State |
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