# VISTA-CLINICA VISUAL

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

## Provider details

- **NPI number:** 1366747198
- **Authorized official:** NIVIANA A. YAMBO OD (OWNER)
- **Authorized official phone:** (787) 840-0303

## Contact information

- **Practice address:** PLAZA SAN CRISTOBAL OFFICE PARK \# 2003, SUITE 102, COTO LAUREL, PR 00780
- **Practice address phone:** (787) 840-0303
- **Mailing address:** PLAZA SAN CRISTOBAL OFFICE PARK \# 2003, SUITE 102, COTO LAUREL, PR 00780
- **Mailing address phone:** (787) 840-0303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152WV0400X | Vision Therapy Optometrist | — | NULL | Yes |
| 152WV0400X | Vision Therapy Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 01/26/2011
- **Last updated:** 01/26/2011