Provider Demographics
NPI:1396571881
Name:OPTOPR2020 LLC
Entity type:Organization
Organization Name:OPTOPR2020 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:SOFIA
Authorized Official - Last Name:RUIZ RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-998-6149
Mailing Address - Street 1:PO BOX 367263
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-7263
Mailing Address - Country:US
Mailing Address - Phone:787-998-6140
Mailing Address - Fax:
Practice Address - Street 1:AVE MUNOZ MARIN
Practice Address - Street 2:AB-8
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-998-6140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier