Healthcare Provider Details

I. General information

NPI: 1437755618
Provider Name (Legal Business Name): VALE OPTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2020
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8699 EAGLE RUN DR
BOCA RATON FL
33434-5408
US

IV. Provider business mailing address

8699 EAGLE RUN DR
BOCA RATON FL
33434-5408
US

V. Phone/Fax

Practice location:
  • Phone: 561-275-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DANIEL GARZA
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 561-720-6423