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General NPI Number Information
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NPI Number | 1598564502
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Entity Type | Organization
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Legal Business Name | COSMIC CONTACT LENSES AND GLASSES LLC
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 2761 NW FEDERAL HWY
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City | STUART
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State | FL
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Zip | 34994-9258
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Country | US
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Telephone | 561-800-4066
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Fax |
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Provider Business Mailing Address
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Address Line | 2761 NW FEDERAL HWY
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City | STUART
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State | FL
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Zip | 34994-9258
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Country | US
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Telephone | 561-800-4066
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Fax |
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Authorized Official
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Title or Position | OWNER LICENSED OPTICIAN
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Name | SHIRLEY ALMODOVAR
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Credential |
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Telephone | 772-206-0476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FC0801X
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Taxonomy Name | Contact Lens Fitter
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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