Eye Express 20-20

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

167 Issued in PR

Legal business name

EYE EXPRESS 20-20

Practice address

Eye Express 20-20, Plaza Rial, Hwy 185, KM .9
Canovanas, PR 00729

Phone

(787) 876-5511

Fax

(787) 876-5511

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Carmen Gladys Garcia

Title

Office Manager

Phone

(787) 876-5511

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ezeagwula Chikwendu Ebube, O.D.

  • Optometrist
  • Canovanas, PR
  • NPI 1720290612
  NPD

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1487866166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 938",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007290938",
            "telephone_number": "787-876-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EYE EXPRESS 20-20, PLAZA RIAL, HWY 185, KM .9",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "787-876-5511",
            "fax_number": "787-876-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE EXPRESS 20-20",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "GLADYS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "787-876-5511",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "PR",
            "license": "167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROSSAM",
            "identifier": "4104-5",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM",
            "identifier": "890103",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenda W Encarnacion Reyes, MASTER SOCIAL WORK
• Equipos Medicos de Canovanas
• ER Medical Managment Group CSP
• Era Transport Corp
• Carol Ivette Escalera-Davila, LCDA.
• Nicole Elizabeth Fana Tanco, ENFERMERA BSN
• Farmacia Belia
• Farmacia Medina 6 Inc
• Farmacia Nieves Inc
• Farmacia Pontezuela 24 LLC

• All providers in Canovanas, PR
• Eyewear Supplier in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.