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General NPI Number Information
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NPI Number | 1962617340
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Entity Type | Organization
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Legal Business Name | PIPA'S OPTICAL, PSC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | EDIFICIO ESTACIONAMIENTO CENTRO MEDICO
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City | SAN JUAN
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State | PR
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Zip | 00927
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Country | US
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Telephone | 787-250-9412
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Fax | 787-281-0803
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Provider Business Mailing Address
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Address Line | PMB 245 PO BOX 70344
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City | SAN JUAN
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State | PR
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Zip | 00936-8344
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Country | US
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Telephone | 787-250-9412
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Fax | 787-281-0803
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA P SIFONTES
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Credential | O.D.
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Telephone | 787-250-9412
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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 | 411
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License Number State | PR
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