| Eye Center Boutique | |
|
1000 The Mall Of Sj Boulevard Suite 118 Urb Villa Olimpia San Juan PR 00924-4043 | |
| (787) 507-5377 | |
| (787) 731-5642 |
| Full Name | Eye Center Boutique |
|---|---|
| Speciality | Eyewear Supplier |
| Location | 1000 The Mall Of Sj Boulevard, San Juan, Puerto Rico |
| Authorized Official Name and Position | Pedro D Salib Frau (PRESIDENT) |
| Authorized Official Contact | 7875075377 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eye Center Boutique 90 Calle Medici Urb Paseo Del Parque San Juan PR 00924-6514 Ph: (787) 507-5377 | Eye Center Boutique 1000 The Mall Of Sj Boulevard Suite 118 Urb Villa Olimpia San Juan PR 00924-4043 Ph: (787) 507-5377 |
| NPI Number | 1144086562 |
|---|---|
| Provider Enumeration Date | 02/23/2024 |
| Last Update Date | 03/01/2024 |
| Certification Date | 02/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144086562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Secondary |
| 332H00000X | Eyewear Supplier | (NU) | Primary |
| 152W00000X | Optometrist | (NU) | Secondary |
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