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General NPI Number Information
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NPI Number | 1023103496
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Entity Type | Organization
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Legal Business Name | FUTURA OPTICAL
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 1846 SW 8 STREET
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City | MIAMI
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State | FL
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Zip | 33135
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Country | US
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Telephone | 305-642-4300
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Fax | 305-644-0845
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Provider Business Mailing Address
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Address Line | 1846 SW 8 STREET
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City | MIAMI
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State | FL
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Zip | 33135
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Country | US
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Telephone | 305-642-4300
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Fax | 305-644-0845
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIO M PEREZ
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Credential | O.D.
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Telephone | 305-642-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | OE-0000764
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License Number State | FL
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