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General NPI Number Information
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NPI Number | 1952576175
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Entity Type | Organization
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Legal Business Name | SHARED INC ABOUT EYES
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 7569 W OAKLAND PARK BLVD
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City | LAUDERHILL
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State | FL
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Zip | 33319-4909
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Country | US
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Telephone | 954-741-6802
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Fax | 954-749-7817
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Provider Business Mailing Address
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Address Line | 7569 W OAKLAND PARK BLVD
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City | LAUDERHILL
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State | FL
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Zip | 33319-4909
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Country | US
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Telephone | 954-741-6802
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Fax | 954-749-7817
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Authorized Official
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Title or Position | OWNER/PRES.
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Name | FRED O BUTTERFIELD
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Credential |
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Telephone | 954-741-6802
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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 | DO 2218
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License Number State | FL
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