Provider Demographics
NPI:1447376322
Name:ECOVISION OPTICAL SERVICES INC
Entity type:Organization
Organization Name:ECOVISION OPTICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAHIRA
Authorized Official - Middle Name:I
Authorized Official - Last Name:DAVILA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-852-1808
Mailing Address - Street 1:PO BOX 5234
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-5234
Mailing Address - Country:US
Mailing Address - Phone:787-852-1808
Mailing Address - Fax:
Practice Address - Street 1:DOLORES CABRERA STREET 2
Practice Address - Street 2:#2 WEST
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00792
Practice Address - Country:US
Practice Address - Phone:787-852-1808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR287152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty