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General NPI Number Information
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NPI Number | 1316454101
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Entity Type | Organization
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Legal Business Name | SIMPLICE CORPORATION
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Dates
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Enumeration Date | 01/03/2018
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Last Update Date | 01/03/2018
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Provider Practice Location Address
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Address Line | 1525 NW 120TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33167-2847
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Country | US
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Telephone | 305-502-1326
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 NW 120TH ST
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City | NORTH MIAMI
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State | FL
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Zip | 33167-2847
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Country | US
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Telephone | 305-502-1326
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Fax |
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Authorized Official
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Title or Position | LICENSE OPTICIAN
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Name | MR. FRANDDY SIMPLICE
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Credential | LDO
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Telephone | 305-502-1326
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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 | DO6774
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License Number State | FL
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