Provider Demographics
NPI:1447471701
Name:OPTICA ROBLES, INC.
Entity type:Organization
Organization Name:OPTICA ROBLES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-878-3186
Mailing Address - Street 1:205 CALLE SAN FELIPE
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-4643
Mailing Address - Country:US
Mailing Address - Phone:787-878-3186
Mailing Address - Fax:787-878-3186
Practice Address - Street 1:205 CALLE SAN FELIPE
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4643
Practice Address - Country:US
Practice Address - Phone:787-878-3186
Practice Address - Fax:787-878-3186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR128152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty