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General NPI Number Information
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NPI Number | 1306020607
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Entity Type | Organization
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Legal Business Name | SANMAR OPTICAL INC.
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 20335 BISCAYNE BLVD SUITE 25
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City | AVENTURA
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State | FL
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Zip | 33180-1503
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Country | US
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Telephone | 305-932-2020
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Fax | 305-932-1948
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Provider Business Mailing Address
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Address Line | 20335 BISCAYNE BLVD SUITE 25
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City | AVENTURA
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State | FL
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Zip | 33180-1503
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Country | US
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Telephone | 305-932-2020
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Fax | 305-932-1948
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Authorized Official
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Title or Position | OPTICIAN/OWNER
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Name | MR. MARK STEVEN EDWARDS
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Credential |
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Telephone | 305-932-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | DO2381
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License Number State | FL
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