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General NPI Number Information
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NPI Number | 1740273879
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Entity Type | Organization
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Legal Business Name | SEA-VIEW OPTICAL INC
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 1715 S FEDERAL HWY SUITE C-1
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City | DELRAY BEACH
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State | FL
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Zip | 33483-3329
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Country | US
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Telephone | 561-276-5099
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Fax | 561-274-9697
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Provider Business Mailing Address
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Address Line | 1715 S FEDERAL HWY SUITE C-1
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City | DELRAY BEACH
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State | FL
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Zip | 33483-3329
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Country | US
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Telephone | 561-276-5099
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Fax | 561-274-9697
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. RICHARD W BERGIDA
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Credential | DO
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Telephone | 561-276-5099
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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 | 1387
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License Number State | FL
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