| Organization Name: | EYE LAND OPTICAL INC |
| NPI Number: | 1093910952 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAUL E LOPEZ (OWNER) |
| Mailing Address: | Street 110 Km 0.3 Aguadilla |
| State: | PR US |
| Postal Code: | 00603 |
| Phone Number: | 7878824189 |
| Fax Number: | 7878820562 |
| NPI Enumeration Date: | 06/19/2007 |
| NPI Last Update Date: | 01/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FC0800X |
| License Number: | 14569 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Contact Lens |
| Taxonomy Definition: | An optician or other ancillary support staff person who, where authorized by state law and trained or certified to do so, may fit or dispense contact lenses to a patient based on the prescription of an optometrist or medical physician. |