Active NPI
Marianela Fred
- Optician
- Corozal, PR
National Provider Identifier
1982334892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 2053306
- Practice address
- Barrio Mavillas Carr 159 KM 16.7 #A3
Corozal, PR 00783 - Phone
- (787) 430-5899
- NPI assigned
- Jun 14, 2022
- Last updated
- Jun 14, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 2053306 | PR | Primary |
Addresses
Primary practice location
Barrio Mavillas Carr 159 KM 16.7 #A3
Corozal, PR 00783
Mailing address
Urb San Fernando Calle 15 C3
Bayamon, PR 00957
Phone (787) 920-2080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2053306 | PR | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optica Real LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Eyewear Supplier
- Corozal, PR
- NPI 1801529714
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1982334892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB SAN FERNANDO CALLE 15 C3",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00957",
"telephone_number": "787-920-2080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BARRIO MAVILLAS CARR 159 KM 16.7 #A3",
"city": "COROZAL",
"state": "PR",
"postal_code": "00783",
"telephone_number": "787-430-5899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRED",
"first_name": "MARIANELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-14",
"last_updated": "2022-06-14",
"certification_date": "2022-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "PR",
"license": "2053306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corozal, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.