Provider Demographics
NPI:1215233424
Name:20/20 OPTICAL,JEIRA INC.
Entity type:Organization
Organization Name:20/20 OPTICAL,JEIRA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:IRASEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:LABOY SAN MIGUEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:939-717-3277
Mailing Address - Street 1:CALLE JOSE DE DIEGO
Mailing Address - Street 2:30
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739
Mailing Address - Country:US
Mailing Address - Phone:787-714-4550
Mailing Address - Fax:787-714-4550
Practice Address - Street 1:CALLE JOSE DE DIEGO
Practice Address - Street 2:30
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-714-4550
Practice Address - Fax:787-714-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty