NPIMap

Organization Active NPI

Pro Vision Optical LLC

  • Optometrist
  • San German, PR
National Provider Identifier
1720712565
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PRO VISION OPTICAL LLC
Practice address
518 A Calle Damas
San German, PR 00683
Phone
(787) 854-9300
Fax
(787) 854-6639
NPI assigned
Jul 15, 2022
Last updated
Jul 15, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PRO VISION OPTICAL LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Authorized official

Name
Mr. Wilson J. Mendez Lugo
Title
Owner
Phone
(787) 854-9300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

518 A Calle Damas
San German, PR 00683

Mailing address

PO Box 851
Manati, PR 00674-0851
Phone (787) 854-9300

Other names 1

  • Pro Vision Optical LLC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Pro Vision Optical Inc3 organizations share this tax ID, including this one
Part of
Pro Vision Optical Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1657843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657843200000",
    "number": "1720712565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 851",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006740851",
            "telephone_number": "787-854-9300",
            "fax_number": "787-854-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 A CALLE DAMAS",
            "city": "SAN GERMAN",
            "state": "PR",
            "postal_code": "00683",
            "telephone_number": "787-854-9300",
            "fax_number": "787-854-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO VISION OPTICAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRO VISION OPTICAL LLC",
        "enumeration_date": "2022-07-15",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A",
        "authorized_official_last_name": "MENDEZ LUGO",
        "authorized_official_first_name": "WILSON",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-854-9300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro Vision Optical LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San German, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.