MEDICARE: HL CENTROVISION GROUP HR 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

General Provider Information

NPI Number	:	1427255132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HL CENTROVISION GROUP HR INC

Provider Business Mailing Address
First Line	:	652 AVE MUNOZ RIVERA
Second Line	:	SUITE 2000
City	:	SAN JUAN
State	:	PR
Zip	:	00918-4257
Country	:	US
Telephone Number	:	787-764-4848
Fax Number	:	787-765-0305

Provider Business Practice Location Address
First Line	:	652 AVE MUNOZ RIVERA
Second Line	:	SUITE 2000
City	:	SAN JUAN
State	:	PR
Zip	:	00918-4257
Country	:	US
Telephone Number	:	787-764-4848
Fax Number	:	787-765-0305

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOACHIM MURATI PORTALATIN
Credential	:
Telephone Number	:	787-764-4848

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	08/22/2020

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