Organization
VISTA CLINICA VISUAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIVIANA A YAMBO-MERCADO OD (PRESIDENT)
(787) 840-4646
Entity
Organization
Contact information
Practice address
1718 CARR 506 STE 101, COTO LAUREL, PR 00780-2948
(787) 840-4646
(787) 840-4646
Mailing address
223 CALLE ISABEL, COTO LAUREL, PR 00780-2601
(787) 840-4646
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WP0200X
Pediatric Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
—
—
Other
Enumeration date
01/10/2019
Last updated
10/28/2021
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