Provider Demographics
NPI:1366919045
Name:OPTICA LAFONT
Entity type:Organization
Organization Name:OPTICA LAFONT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LUZ
Authorized Official - Last Name:BONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-205-8843
Mailing Address - Street 1:45 CALLE RUIZ BELVIS
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3552
Mailing Address - Country:US
Mailing Address - Phone:787-743-5785
Mailing Address - Fax:787-743-0222
Practice Address - Street 1:45 CALLE RUIZ BELVIS
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3552
Practice Address - Country:US
Practice Address - Phone:787-743-5785
Practice Address - Fax:787-743-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty