M&M Optical Shop Corp
Organization Active NPI Optometrist · Guaynabo, PR
NPI 1356935340 · NPPES record last updated Feb 22, 2021
Key facts
- NPI
- 1356935340
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- M&M OPTICAL SHOP CORP
- Practice address
- 130 Marginal MTZ Nadal
Los Jardines Shopping Ctr
Guaynabo, PR 00969-0096 - Phone
- (787) 625-9144
- NPI assigned
- Feb 22, 2021
- Organization subpart
- No
Authorized official
- Name
- Francis D Medina
- Title
- Owner
- Phone
- (787) 625-9144
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 2
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250725003585 | PR | Part B Supplier - Clinic/Group Practice | 1557878451 |
Receives reassigned benefits from 2 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Guaynabo, PR; San Juan, PR |
National Provider Directory
- Tax ID family
- Grupo Optometrico Altamira LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes | ||
| Optician |
156FX1800X |
Addresses
Primary practice location
130 Marginal MTZ Nadal
Los Jardines Shopping Ctr
Guaynabo, PR 00969-0096
Mailing address
PMB 333 P.O.Box 7891
Guaynabo, PR 00970
Phone (787) 648-0457
Other names
- opti-k express
Other providers in Guaynabo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.