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Organization

VISION OUTLET LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JUAN R GOMEZ LOPEZ (PRESIDENTE)
(787) 852-2470
Entity
Organization

Contact information

Practice address
216 VILLA UNIVERSITARIA, VILLA STATION, HUMACAO, PR 00791-3605
(787) 852-2470
(787) 285-8093
Mailing address
5 CALLE DUFRESNE E, HUMACAO, PR 00791-3605
(787) 852-2470
(787) 285-8093

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
392241
PR

Other

Enumeration date
03/13/2017
Last updated
03/13/2017
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