Provider Demographics
NPI:1427805860
Name:OPTIQUETTE LLC
Entity type:Organization
Organization Name:OPTIQUETTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:THAMARA
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-890-2629
Mailing Address - Street 1:60401 PMB 151
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:PR
Mailing Address - Zip Code:00690
Mailing Address - Country:US
Mailing Address - Phone:787-890-2629
Mailing Address - Fax:888-351-6173
Practice Address - Street 1:CALLE MATOMAS 2906
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:PR
Practice Address - Zip Code:00690
Practice Address - Country:US
Practice Address - Phone:787-890-2629
Practice Address - Fax:888-351-6173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty