# CENTRO VISUAL MATOS

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

## Provider details

- **NPI number:** 1902396179
- **Authorized official:** DR. MYLTHIA P MATOS OD (OPTHOMETRIST)
- **Authorized official phone:** (787) 379-9070

## Contact information

- **Practice address:** 191 AVE BETANCES, BAYAMON, PR 00959-5159
- **Practice address phone:** (787) 787-8555
- **Mailing address:** CAPE SEA VILLAGE, 3 GARDENIA 115, CAROLINA, PR 00979
- **Mailing address phone:** (787) 379-9070

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/14/2018
- **Last updated:** 05/14/2018