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General NPI Number Information
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NPI Number | 1942735089
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Entity Type | Organization
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Legal Business Name | AMERICA OPTICAL AB GROUP CORP
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Dates
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Enumeration Date | 04/26/2017
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 1377 S MILITARY TRL
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-7634
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Country | US
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Telephone | 954-482-0030
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Fax | 954-531-6938
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Provider Business Mailing Address
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Address Line | 1377 S MILITARY TRL
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-7634
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Country | US
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Telephone | 954-482-0030
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Fax | 954-531-6938
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAYZA M DE SOUZA
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Credential |
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Telephone | 954-482-0030
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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 | 1359
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License Number State | FL
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