Organization
BRAIN & VISION BOUTIQUE
Active
Parent organization
BRAIN & VISION, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRAIN & VISION, LLC
Authorized official
DR. JOVANNY ULLOA OD (OPTOMETRIST/OWNER)
(939) 336-4584
Entity
Organization
Contact information
Practice address
701 AVE. PONCE DE LEON, EDF CENTRO DE SEGUROS SUITE 108-B, SAN JUAN, PR 00907
(787) 223-8752
Mailing address
78 CALLE CORALINA, SAN JUAN, PR 00926-9634
(787) 210-6092
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
12/20/2022
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