1346890159 NPI number — MRS. JESSICA ALICEA BARRIERA OPTICO LICENCIADO

Table of content: MRS. JESSICA ALICEA BARRIERA OPTICO LICENCIADO (NPI 1346890159)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346890159 NPI number — MRS. JESSICA ALICEA BARRIERA OPTICO LICENCIADO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALICEA BARRIERA
Provider First Name:
JESSICA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OPTICO LICENCIADO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZOOM OPTICAL
Provider Other First Name:
NEW
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NEW ZOOM OPTICAL
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1346890159
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/03/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB PASEO DE LA CEIBA 212 CALLE ARECA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JUNCOS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00777
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-206-6753
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 CALLE DUFRESNE W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUMACAO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00791-3601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-223-5932
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/13/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 156FX1800X , with the licence number:  1377 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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