| Organization Name: | IMAGEN OPTICA |
| NPI Number: | 1730316621 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BENJAMIN CASTRO (PRESIDENT) |
| Mailing Address: | 112 Calle Luis Munoz Rivera Vieques |
| State: | PR US |
| Postal Code: | 007653042 |
| Phone Number: | 7877414969 |
| Fax Number: | |
| NPI Enumeration Date: | 06/17/2009 |
| NPI Last Update Date: | 06/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 267 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |