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General NPI Number Information
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NPI Number | 1962973685
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Entity Type | Organization
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Legal Business Name | BUSTELOS OPTICAL, INC
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Dates
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Enumeration Date | 12/06/2018
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 4813 SW 8TH ST
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City | CORAL GABLES
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State | FL
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Zip | 33134-2522
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Country | US
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Telephone | 786-308-9960
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Fax | 786-431-1782
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Provider Business Mailing Address
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Address Line | 2823 SW 36TH CT
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City | MIAMI
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State | FL
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Zip | 33133-3421
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Country | US
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Telephone | 786-308-9960
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NASHIELI GARCIA
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Credential |
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Telephone | 786-308-9960
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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 |
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License Number State |
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