Organization
LENS OUTLET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIS J TORRES-MEDINA OP (PRESIDENT/OWNER)
(787) 844-0346
Entity
Organization
Contact information
Practice address
BOULEVARD LUIS A FERRE 2165, PONCE, PR 00717-0725
(787) 844-0346
Mailing address
VALLE VERDE, 769 CALLE RIACHUELO, PONCE, PR 00716
(787) 844-0346
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
822
PR
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037879001
—
PR
Enumeration date
07/12/2016
Last updated
08/05/2024
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