Millennium Vision Center PSC

Primary specialty

OptometristTaxonomy code 152W00000X

License

391 Issued in PR

Legal business name

MILLENNIUM VISION CENTER PSC

Doing business as

Pearle Vision

Practice address

Pearle Vision
5829 Plaza Escorial Suite 105
Carolina, PR 00987

Phone

(787) 276-3435

Fax

(787) 276-4835

NPI assigned

Mar 12, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Edison Marin, O.D.NPI 1063504439

Title

President

Phone

(787) 276-3435

Specialties & licenses 1

Addresses

Other names 1

• Pearle Vision Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edison Marin, O.D.

  • Optometrist
  • Carolina, PR
  • NPI 1063504439
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255463584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PEARLE VISION",
            "address_2": "5829 PLAZA ESCORIAL SUITE 105",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "787-276-3435",
            "fax_number": "787-276-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEARLE VISION",
            "address_2": "5829 PLAZA ESCORIAL SUITE 105",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00987",
            "telephone_number": "787-276-3435",
            "fax_number": "787-276-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM VISION CENTER PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARIN",
        "authorized_official_first_name": "EDISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-276-3435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "PR",
            "license": "391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Giovanni Antonio Mictil, MSN - CRNA
• Midtown Radiology Services Inc
• Milab LLC
• Ismenio Millan-Aponte, MD
• Iris M Millan, RPH
• Katia Natasha Miller Pagan
• Karen Lucille Mir-Badillo, PH.D.
• Edgar Javier Miranda Gonzalez
• Paloma Cristal Miranda Malaret, PHARMD
• Rafael Miranda Malave, M.D.

• Optometrist in Carolina, PR
• Providers in Carolina, PR by specialty
• Optometrist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.