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General NPI Number Information
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NPI Number | 1841916178
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Entity Type | Organization
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Legal Business Name | FAMILY VISION CENTER JUANA DIAZ
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Dates
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Enumeration Date | 10/18/2022
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | PLAZA JUANA DIAZ CARR 149 LOCAL 6
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone | 787-260-2588
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Fax | 787-813-0843
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Provider Business Mailing Address
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Address Line | GALERIAS PONCENAS MALL CALLE UNION 83 SUITE 129
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City | PONCE
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State | PR
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Zip | 00730
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Country | US
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Telephone | 787-844-6000
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Fax | 787-813-0843
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. HEILEN M DE LA HOZ
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Credential |
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Telephone | 787-643-9250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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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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