| NPI | 1811621659 |
|---|---|
| Former Legal Business Name | PRO VISION OPTICAL LLC |
| Entity Type | Organization |
| Authorized Contact | WILSON J. MENDEZ LUGO Owner 787-854-9300 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2022-07-15 |