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General NPI Number Information
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NPI Number | 1801229943
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Entity Type | Organization
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Legal Business Name | CLINICA VISUAL VILLALBA
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Dates
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Enumeration Date | 08/13/2013
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 18 CALLE MUNOZ RIVERA
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City | VILLALBA
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State | PR
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Zip | 00766-2227
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Country | US
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Telephone | 787-847-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 18 CALLE MUNOZ RIVERA
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City | VILLALBA
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State | PR
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Zip | 00766-2227
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTICIAN
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Name | ALBERT RIVERA
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Credential |
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Telephone | 787-216-8006
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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 | 653
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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 | 694
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 906
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License Number State | PR
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