Provider Demographics
NPI:1871601419
Name:APOLOVISION,INC
Entity type:Organization
Organization Name:APOLOVISION,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:FERNANDEZ-MOLL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-790-1622
Mailing Address - Street 1:CAM. ALEJANDRINO B-7
Mailing Address - Street 2:VILLA CLEMENTINA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-720-4544
Mailing Address - Fax:787-790-1622
Practice Address - Street 1:CAM. ALEJANDRINO B-7
Practice Address - Street 2:VILLA CLEMENTINA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-720-4544
Practice Address - Fax:787-790-1622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0247261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR101019OtherI-VISION INTERNATIONAL
PR=========OtherMCS CLASSICARE
PR=========Medicare UPIN
PR2914Medicare UPIN
PR6570076Medicare UPIN
PR051380Medicare UPIN
PR00112Medicare UPIN
PR101019OtherI-VISION INTERNATIONAL