Organization
BE PROFESSIONAL,PSC
Active
Other names
ATLANTIS OPTICAL
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE BAEZ (PRESIDENT)
(939) 246-1079
Entity
Organization
Contact information
Practice address
AVE MONSERRATE # 97, NUMERO 28 VILLA CAROLINA, CAROLINA, PR 00985-5444
(939) 246-1079
(186) 689-9305
Mailing address
PO BOX 6029, PMB 2296, CAROLINA, PR 00984-6029
(939) 246-1079
(186) 689-9305
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WL0500X
Low Vision Rehabilitation Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
—
—
152WX0102X
Occupational Vision Optometrist
—
—
156FC0800X
Contact Lens Technician/Technologist
—
—
156FC0801X
Contact Lens Fitter
—
—
156FX1201X
Optometric Assistant Technician
—
—
156FX1202X
Optometric Technician
—
—
156FX1800X
Optician
480
PR
174H00000X
Health Educator
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
312449
CORPORATE ID NUMBER
PR
Enumeration date
12/26/2012
Last updated
12/26/2012
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