Healthcare Provider Details
I. General information
NPI: 1457860371
Provider Name (Legal Business Name): GLASSES RX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2017
Last Update Date: 01/26/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1236 JACARANDA BLVD
VENICE FL
34292-4507
US
IV. Provider business mailing address
1360 E VENICE AVE
VENICE FL
34285-9066
US
V. Phone/Fax
- Phone: 941-496-4444
- Fax: 941-496-4223
- Phone: 941-488-2020
- Fax: 941-484-2200
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MICHAEL
KRISZTINA
AMES
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 941-233-5802