Provider Demographics
NPI:1124166517
Name:HAINES, FRANCES
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:HAINES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2223
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-2239
Mailing Address - Country:US
Mailing Address - Phone:787-887-7062
Mailing Address - Fax:787-887-7062
Practice Address - Street 1:GARCIA DE LA NOCEDA #4-A VILLAS DE RIO GRANDE
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745
Practice Address - Country:US
Practice Address - Phone:787-887-7062
Practice Address - Fax:787-887-7062
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR177152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR58068Medicare ID - Type Unspecified