Organization Active NPI

LK Optics LLC

Doing business as Mirada Optical

  • Health Service Clinic/Center
  • San Juan, PR
National Provider Identifier
1417673419
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
LK OPTICS LLC
Doing business as
Mirada Optical
Practice address
1573 Avenida Jesus T. Pinero
San Juan, PR 00920
Phone
(787) 400-0555
NPI assigned
Oct 12, 2022
Last updated
Oct 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Authorized official

Name
Kiara E Velilla
Title
Administrator
Phone
(787) 400-0555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

1573 Avenida Jesus T. Pinero
San Juan, PR 00920

Mailing address

Los Eucaliptos 17015
Price Drive
Canovanas, PR 00729
Phone (787) 400-0555

Other names 1

  • MIRADA OPTICAL Doing business as

National Provider Directory

National Provider Directory

Locations

1573 Ave Jesus T Pinero
San Juan, PR 00920
Phone (787) 400-0555

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1417673419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LOS EUCALIPTOS 17015",
            "address_2": "PRICE DRIVE",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "787-400-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 AVENIDA JESUS T. PINERO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00920",
            "telephone_number": "787-400-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LK OPTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "VELILLA",
        "authorized_official_first_name": "KIARA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-400-0555"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIRADA OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.