Organization
VISTA CARE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISANIA CORE O.D. (OPTOMETRIST)
(787) 995-2450
Entity
Organization
Contact information
Practice address
P60 AVE SANTA JUANITA, BAYAMON, PR 00956-4954
(787) 995-2450
(787) 787-2424
Mailing address
P60 AVE SANTA JUANITA, BAYAMON, PR 00956-4954
(787) 995-2450
(787) 787-2424
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
542
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4871890001
PALMETTO
PR
01
—
601012
MMM
PR
Enumeration date
10/13/2006
Last updated
08/22/2020
Update your record
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