Healthcare Provider Details

I. General information

NPI: 1851845051
Provider Name (Legal Business Name): PRISTINE EYESIGHT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2016
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11402 NW 41ST ST STE 121
DORAL FL
33178-4862
US

IV. Provider business mailing address

7523 W 31ST AVE
HIALEAH FL
33018-5237
US

V. Phone/Fax

Practice location:
  • Phone: 305-239-5890
  • Fax:
Mailing address:
  • Phone: 786-525-6717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC 5250
License Number StateFL

VIII. Authorized Official

Name: BELKIS PEREZ
Title or Position: PRESIDENT
Credential: O.D.
Phone: 786-525-6717