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General NPI Number Information
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NPI Number | 1831478643
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Entity Type | Organization
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Legal Business Name | FOR EYES OPTICAL CO. OF COCONUT GROVE, FL
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 285 W 74TH PL
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City | HIALEAH
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State | FL
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Zip | 33014-5058
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Country | US
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Telephone | 305-557-9004
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 102472
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City | ATLANTA
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State | GA
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Zip | 30368-2472
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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 | VP., OF MANAGED VISION CARE
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Name | MRS. MARIA OLIVER
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Credential |
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Telephone | 513-292-4137
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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 |
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License Number State |
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