Boulevard Visual Clinic

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

163611 Issued in PR

Legal business name

BOULEVARD VISUAL CLINIC

Practice address

Urb. Levittown Lakes Ee-10
Calle Jose S Alegria
Toa Baja, PR 00949-2718

Phone

(787) 261-5333

Fax

(787) 261-5333

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jose Antonio Cotto, O.D.

Title

Presidente

Phone

(787) 261-5333

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1821171109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50707",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009500707",
            "telephone_number": "787-261-5333",
            "fax_number": "787-261-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. LEVITTOWN LAKES EE-10",
            "address_2": "CALLE JOSE S ALEGRIA",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009492718",
            "telephone_number": "787-261-5333",
            "fax_number": "787-261-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULEVARD VISUAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "COTTO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-261-5333",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "PR",
            "license": "163611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Toa Baja, PR
• Providers in Toa Baja, PR by specialty
• Eyewear Supplier in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; 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.