Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1265 | PR |
NPI | 1194266619 |
---|---|
Provider Name | Mrs. Lizamar Oquendo |
First Address | Cayey, PR 00737-5361 |
Second Address | Cayey, PR 00737-5361 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2017 |
Last Update Date | 16/03/2017 |