Opticenter Loiza Valley

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

750 Issued in PR

Legal business name

OPTICENTER LOIZA VALLEY

Practice address

Aa10
Loizavalley Shopping Center
Canovanas, PR 00729

Phone

(787) 876-0820

Fax

(787) 876-0820

NPI assigned

Apr 24, 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

Mr. Israel Antonio Cabrera

Title

Licenciado Optico

Phone

(787) 876-0820

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518186345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EDIFICIO AA10",
            "address_2": "LOIZAVALLEY MALL",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "787-876-0820",
            "fax_number": "787-876-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AA10",
            "address_2": "LOIZAVALLEY SHOPPING CENTER",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "787-876-0820",
            "fax_number": "787-876-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICENTER LOIZA VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CABRERA",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "LICENCIADO OPTICO",
        "authorized_official_telephone_number": "787-876-0820",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "PR",
            "license": "750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Canovanas, PR
• Providers in Canovanas, PR by specialty
• Point of Service 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.