| Organization Name: | KEM - JIREH OPTICAL |
| NPI Number: | 1073854212 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EMANUEL VELAZQUEZ (LICENCIADO) |
| Mailing Address: | Carr 195 Km 4.5 Bo Campo Rico Canovanas |
| State: | PR US |
| Postal Code: | 00729 |
| Phone Number: | 7873647761 |
| Fax Number: | 7876554656 |
| NPI Enumeration Date: | 03/13/2013 |
| NPI Last Update Date: | 04/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156F00000X |
| License Number: | 586 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A broad category grouping different kinds of technologists and technicians. See individual definitions. |