# CENTRO DIVA, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CENTRO DIVA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447585856
- **Authorized official:** DR. TIRSA M QUINONES O.D. (OPTOMETRIC SERVICES DIRECTOR)
- **Authorized official phone:** (787) 812-3518

## Contact information

- **Practice address:** 2830 AVE LAS AMERICAS, PONCE, PR 00717-2100
- **Practice address phone:** (787) 812-3518
- **Practice address fax:** (787) 812-3749
- **Mailing address:** 2830 AVE LAS AMERICAS, PONCE, PR 00717-2100
- **Mailing address phone:** (787) 812-3518
- **Mailing address fax:** (787) 812-3749

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152WV0400X | Vision Therapy Optometrist | 88 | PR | Yes |

## Other

- **Enumeration date:** 10/03/2009
- **Last updated:** 10/03/2009