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General NPI Number Information
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NPI Number | 1558847608
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Entity Type | Organization
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Legal Business Name | PUBLIC EYE OPTICAL, PA
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Dates
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Enumeration Date | 07/12/2018
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Last Update Date | 07/12/2018
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Provider Practice Location Address
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Address Line | 537 SW 12TH AVE
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City | MIAMI
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State | FL
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Zip | 33130-2413
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Country | US
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Telephone | 419-215-7696
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 BAY RD APT 1515
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City | MIAMI BEACH
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State | FL
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Zip | 33139-3275
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JUSTIN TURNER
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Credential | OD
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Telephone | 419-215-7696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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