Provider Demographics
NPI:1366933822
Name:VISION CARE PUERTO RICO
Entity type:Organization
Organization Name:VISION CARE PUERTO RICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:STABILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-242-1920
Mailing Address - Street 1:GH-1 AVENIDA LAUREL URB, SANTA JUANTIA
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-242-1920
Mailing Address - Fax:
Practice Address - Street 1:GH-1 AVENIDA LAUREL URB, SANTA JUANTIA
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-242-1920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty