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General NPI Number Information
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NPI Number | 1114479714
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Entity Type | Organization
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Legal Business Name | FABILENS CORP
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Dates
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Enumeration Date | 10/29/2016
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Last Update Date | 10/24/2017
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Provider Practice Location Address
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Address Line | 7450 NW 104TH AVE UNIT C103
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City | DORAL
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State | FL
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Zip | 33178-3360
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Country | US
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Telephone | 786-228-7932
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Fax |
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Provider Business Mailing Address
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Address Line | 7450 NW 104TH AVE UNIT C103
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City | DORAL
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State | FL
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Zip | 33178-3360
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Country | US
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Telephone | 786-228-7932
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. FRANCO ENCINA
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Credential |
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Telephone | 786-228-7932
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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 | DO6821
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC3384
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License Number State | FL
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