| NPI | 1407575475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDRIC VIVONI Member 787-286-0941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2022-08-24 |