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General NPI Number Information
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NPI Number | 1932240199
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Entity Type | Organization
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Legal Business Name | VERSAILLES OPTICAL INC.
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5434 SW 8TH ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-2267
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Country | US
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Telephone | 305-444-8676
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Fax | 305-444-5181
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Provider Business Mailing Address
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Address Line | 5434 SW 8TH ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-2267
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Country | US
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Telephone | 305-444-8676
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Fax | 305-444-5181
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Authorized Official
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Title or Position | PRESIDENT
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Name | LORENZO I DE TORO
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Credential |
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Telephone | 305-444-8676
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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 | 1499284
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License Number State | FL
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