Provider Demographics
NPI:1306453618
Name:WORLD VISION OPTICAL & LAB
Entity type:Organization
Organization Name:WORLD VISION OPTICAL & LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-778-2957
Mailing Address - Street 1:URB. SANTA JUANITA
Mailing Address - Street 2:AVE, SANTA JUANITA L-56
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-778-2957
Mailing Address - Fax:787-778-2957
Practice Address - Street 1:URB. SANTA JUANITA
Practice Address - Street 2:AVE, SANTA JUANITA L-56
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-778-2957
Practice Address - Fax:787-778-2957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty