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NPI Code Detail

MEDICARE: VISTA-CLINICA VISUAL

MEDICARE: VISTA-CLINICA VISUAL
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
1152WV0400XVision Therapy Optometrist

General Provider Information

NPI Number : 1366747198
Entity Type Code : Organization
Provider Name (Legal Business Name) : VISTA-CLINICA VISUAL
Provider Business Mailing Address
First Line : PLAZA SAN CRISTOBAL OFFICE PARK # 2003
Second Line : SUITE 102
City : COTO LAUREL
State : PR
Zip : 00780
Country : US
Telephone Number : 787-840-0303
Fax Number :
Provider Business Practice Location Address
First Line : PLAZA SAN CRISTOBAL OFFICE PARK # 2003
Second Line : SUITE 102
City : COTO LAUREL
State : PR
Zip : 00780
Country : US
Telephone Number : 787-840-0303
Fax Number :
Authorized Official
Title or Position : OWNER
Name : NIVIANA A. YAMBO
Credential : OD
Telephone Number : 787-840-0303
Provider Enumeration Date : 01/26/2011
Last Update Date : 01/26/2011

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Practice Location Address:
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Directions to “VISTA-CLINICA VISUAL ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.