| NPI | 1104604768 |
|---|---|
| Doing Business As | EYE CENTER BOUTIQUE |
| Entity Type | Organization |
| Authorized Contact | GABRIEL SANTOS President 787-801-5896 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2024-05-07 |