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General NPI Number Information
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NPI Number | 1770885097
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Entity Type | Organization
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Legal Business Name | IRIS OPTIQUE INC.
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Dates
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Enumeration Date | 11/18/2010
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Last Update Date | 01/18/2011
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Provider Practice Location Address
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Address Line | 225 MIRACLE MILE
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City | CORAL GABLES
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State | FL
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Zip | 33134-5907
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Country | US
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Telephone | 305-442-4747
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Fax | 305-442-4646
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Provider Business Mailing Address
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Address Line | 225 MIRACLE MILE
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City | CORAL GABLES
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State | FL
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Zip | 33134-5907
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Country | US
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Telephone | 305-442-4747
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Fax | 305-442-4646
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Authorized Official
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Title or Position | PRESIDENT
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Name | IRIS GONZALEZ
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Credential |
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Telephone | 305-442-4747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | OE1967
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State | FL
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