MEDICARE: EYE & OPTICS VISION CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	466	PR

General Provider Information

NPI Number	:	1083834329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE & OPTICS VISION CARE INC.

Provider Business Mailing Address
First Line	:	271 CALLE SIERRA MORENA
Second Line	:	LA CUMBRE
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5539
Country	:	US
Telephone Number	:	787-708-5821
Fax Number	:	787-708-5838

Provider Business Practice Location Address
First Line	:	271 AVE EMILIANO POL
Second Line	:	LA CUMBRE
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5539
Country	:	US
Telephone Number	:	787-708-5838
Fax Number	:	787-708-5838

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JENNIFER MARIE ALSINA
Credential	:	OPTOMETRIST
Telephone Number	:	787-708-5838

Provider Enumeration Date	:	04/27/2007
Last Update Date	:	01/14/2010

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