# VISTA CARE PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215027859
- **Authorized official:** DR. LISANIA CORE O.D. (OPTOMETRIST)
- **Authorized official phone:** (787) 995-2450

## Contact information

- **Practice address:** P60 AVE SANTA JUANITA, BAYAMON, PR 00956-4954
- **Practice address phone:** (787) 995-2450
- **Practice address fax:** (787) 787-2424
- **Mailing address:** P60 AVE SANTA JUANITA, BAYAMON, PR 00956-4954
- **Mailing address phone:** (787) 995-2450
- **Mailing address fax:** (787) 787-2424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 542 | PR | Yes |

## Other

- **Enumeration date:** 10/13/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4871890001 | PALMETTO | PR |
| 01 | — | 601012 | MMM | PR |