Provider Demographics
NPI:1316318769
Name:OPTIFARMA LLC
Entity type:Organization
Organization Name:OPTIFARMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SEGARRA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-202-0251
Mailing Address - Street 1:1232 AVE. MUNOZ RIVERA
Mailing Address - Street 2:REPARTO UNIVERSITARIO
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-202-0251
Mailing Address - Fax:
Practice Address - Street 1:1232 AVE. MUNOZ RIVERA
Practice Address - Street 2:REPARTO UNIVERSITARIO
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-202-0251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-12
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier