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General NPI Number Information
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NPI Number | 1427255751
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Entity Type | Organization
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Legal Business Name | CAPPUCCIO ENTERPRISE
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 08/28/2007
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Provider Practice Location Address
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Address Line | 2140 EAST OAKLAND PARK BOULEVARD
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City | FT.LAUDERDALE
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State | FL
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Zip | 33306
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Country | US
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Telephone | 954-563-5331
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Fax | 954-563-9979
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Provider Business Mailing Address
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Address Line | 2140 EAST OAKLAND PARK BOULEVARD
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City | FT.LAUDERDALE
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State | FL
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Zip | 33306
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Country | US
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Telephone | 954-563-5331
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Fax | 954-563-9979
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Authorized Official
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Title or Position | OWNER
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Name | MR. WILLIAM J CAPPUCCIO
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Credential | OPTICIAN
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Telephone | 954-563-5331
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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 |
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License Number State |
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