Healthcare Provider Details

I. General information

NPI: 1265704233
Provider Name (Legal Business Name): GLASSES RX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2012
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 S MCCALL RD
ENGLEWOOD FL
34223-4958
US

IV. Provider business mailing address

1360 E VENICE AVE
VENICE FL
34285-9066
US

V. Phone/Fax

Practice location:
  • Phone: 941-474-2020
  • Fax: 941-473-4142
Mailing address:
  • Phone: 941-488-2020
  • Fax: 941-484-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL AMES
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 941-233-5802