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General NPI Number Information
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NPI Number | 1851515852
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Entity Type | Organization
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Legal Business Name | INSTITUTO CLINICO OPTOMETRICO
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | AVE BAIROA AB 9 URB BAIROA
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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 | 787-703-0285
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Fax | 787-703-0285
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Provider Business Mailing Address
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Address Line | AB 9 BAIROA AVE URB BAIROA
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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 | 787-703-0285
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Fax | 787-703-0285
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Authorized Official
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Title or Position | OPTOMETRIST/PRESIDENT
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Name | MR. ALEXANDER FRANQUIZ
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Credential | O.D.
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Telephone | 787-703-0285
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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 | 453
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License Number State | PR
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