Angel Diaz Marti

Individual provider Active NPI Optician · Carolina, PR

NPI 1629811963 · NPPES record last updated Jun 14, 2024

Key facts

NPI
1629811963
Entity type
Individual (NPI type 1)
Primary specialty
Optician 156FX1800X
License
234 (PR)
Practice address
Plaz Escorial
Carolina, PR 00987
Phone
(787) 257-0500
NPI assigned
Jun 14, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
234PRMDOptician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 234 PR Yes

Addresses

Primary practice location

Plaz Escorial
Carolina, PR 00987

Mailing address

Calle B # 21 la Antillana
Lago Alto
Trujillo Alto, PR 00976
Phone (787) 410-1674

Other providers in Carolina, PR

All providers in Carolina, PR · Optician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.