Healthcare Provider Details
I. General information
NPI: 1003646886
Provider Name (Legal Business Name): SNG LABS-SNG PROSTHETIC EYE INSTITUTE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2024
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12750 NW 17TH ST UNIT 201
MIAMI FL
33182-1422
US
IV. Provider business mailing address
16244 S MILITARY TRL STE 420
DELRAY BEACH FL
33484-6505
US
V. Phone/Fax
- Phone: 561-391-7099
- Fax: 561-354-5367
- Phone: 561-391-7099
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICOLE
GARONZIK
Title or Position: OWNER
Credential:
Phone: 561-391-7099