| NPI | 1043855919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILFREDO GAUDINO Owner 787-420-0783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2021-09-01 |