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General NPI Number Information
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NPI Number | 1437180510
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Entity Type | Organization
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Legal Business Name | DEERFIELD OPTICIANS INC
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1400 E HILLSBORO BLVD SUITE 101
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-4202
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Country | US
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Telephone | 954-426-2314
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Fax | 954-480-9670
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Provider Business Mailing Address
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Address Line | 1400 E HILLSBORO BLVD SUITE 101
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-4202
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Country | US
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Telephone | 954-426-2314
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Fax | 954-480-9670
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JILL DEANN ELLIS
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Credential |
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Telephone | 954-426-2314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | DO2468
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License Number State | FL
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