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General NPI Number Information
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NPI Number | 1558536466
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Entity Type | Organization
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Legal Business Name | ARCADIA EYEWEAR INC.
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 14 S POLK AVE
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City | ARCADIA
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State | FL
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Zip | 34266-3950
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Country | US
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Telephone | 863-993-9911
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Fax | 863-993-1022
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Provider Business Mailing Address
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Address Line | 14 S POLK AVE
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City | ARCADIA
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State | FL
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Zip | 34266-3950
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Country | US
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Telephone | 863-993-9911
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Fax | 863-993-1022
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Authorized Official
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Title or Position | PRESIDENT / OPTICIAN
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Name | MRS. DEBORAH JEAN FANTIN
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Credential | DO
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Telephone | 863-993-9911
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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 | DO 4027
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License Number State | FL
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