Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | NONE | PR |
N | 156FC0801X | Contact Lens Fitter | NONE | PR |
N | 156FX1101X | Ophthalmic Assistant | NONE | PR |
Y | 156FX1800X | Optician | 674 | PR |
NPI | 1457669160 |
---|---|
Provider Name | Belen Maldonado |
First Address | San Juan, PR 00908-1241 |
Second Address | San Juan, PR 00912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2010 |
Last Update Date | 15/09/2010 |