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General NPI Number Information
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NPI Number | 1376646570
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Entity Type | Organization
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Legal Business Name | ALLAN'S OPTICAL & LABORATORY
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 07/19/2007
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Provider Practice Location Address
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Address Line | 3399 NW 72ND AVE SUITE 114
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City | MIAMI
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State | FL
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Zip | 33122-1349
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Country | US
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Telephone | 305-591-0027
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Fax | 305-591-3355
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Provider Business Mailing Address
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Address Line | 3399 NW 72ND AVE SUITE 114
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City | MIAMI
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State | FL
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Zip | 33122-1349
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Country | US
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Telephone | 305-591-0027
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Fax | 305-591-3355
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Authorized Official
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Title or Position | OPTICIAN
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Name | CARLOS ALLAN MACHADO
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Credential |
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Telephone | 305-591-0027
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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 | DO5411
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License Number State | FL
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