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General NPI Number Information
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NPI Number | 1861531816
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Entity Type | Organization
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Legal Business Name | OPTICA DE LA CRUZ INC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 1060 CALLE BRUMBAUGH
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City | SAN JUAN
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State | PR
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Zip | 00925-2914
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Country | US
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Telephone | 787-765-4028
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Fax | 787-767-2221
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Provider Business Mailing Address
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Address Line | 1060 CALLE BRUMBAUGH
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City | SAN JUAN
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State | PR
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Zip | 00925-2914
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Country | US
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Telephone | 787-765-4028
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Fax | 787-767-2221
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LUCY DE LA CRUZ
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Credential | OPTICIAN
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Telephone | 787-767-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 024
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License Number State | PR
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