Boulevard Visual Clinic

NPI #1821171109 in Toa Baja, Puerto Rico

Provider Information

NPI Number: 1821171109
Entity Type: Organization
Organization Name: Boulevard Visual Clinic
Primary Specialty: Eyewear Supplier
Enumeration Date: Oct 23, 2006
Last Updated: Dec 9, 2008

Practice Location

Address: URB. LEVITTOWN LAKES EE-10
Address 2: CALLE JOSE S ALEGRIA
City: Toa Baja
State: Puerto Rico
ZIP Code: 00949-2718
Phone: (787) 261-5333

Authorized Official

Name: MR. JOSE ANTONIO COTTO, O.D.
Title: PRESIDENTE
Phone: (787) 261-5333

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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