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General NPI Number Information
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NPI Number | 1447396767
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Entity Type | Organization
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Legal Business Name | DISCOUNT EYEGLASS OUTLET
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 14590 MILITARY TRL SUITE E-1
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City | DELRAY BEACH
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State | FL
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Zip | 33484-3757
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Country | US
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Telephone | 561-637-4071
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Fax | 561-637-4072
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Provider Business Mailing Address
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Address Line | 14590 MILITARY TRL SUITE E-1
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City | DELRAY BEACH
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State | FL
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Zip | 33484-3757
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Country | US
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Telephone | 561-637-4071
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Fax | 561-637-4072
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE E GILTMAN
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Credential | LIC OPTICIAN
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Telephone | 561-637-4071
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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 | D05042
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License Number State | FL
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