Organization
MY OPTICAL FACTORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA E VILLALOBOS OD (PRESIDENT)
(787) 860-4090
Entity
Organization
Contact information
Practice address
#61 CALLE GARRIDO MORALES W, FAJARDO, PR 00738
(787) 860-4090
(787) 863-5515
Mailing address
PO BOX 1400, FAJARDO, PR 00738-1400
(787) 860-4090
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
JM124
—
PR
Enumeration date
05/20/2020
Last updated
05/20/2020
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