MEDICARE: SUAL OPTICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1100X	Ophthalmic Technician/Technologist

General Provider Information

NPI Number	:	1386843795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUAL OPTICAL CORPORATION

Provider Business Mailing Address
First Line	:	10720 W FLAGLER ST
Second Line	:	SUITE 6
City	:	MIAMI
State	:	FL
Zip	:	33174-4406
Country	:	US
Telephone Number	:	305-551-1245
Fax Number	:

Provider Business Practice Location Address
First Line	:	10720 W FLAGLER ST
Second Line	:	SUITE 6
City	:	MIAMI
State	:	FL
Zip	:	33174-4406
Country	:	US
Telephone Number	:	305-551-1245
Fax Number	:

Authorized Official
Title or Position	:	OWNER OPTICIAN
Name	:	LINO ALVAREZ
Credential	:
Telephone Number	:	305-551-1245

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	08/22/2020

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Directions to “SUAL OPTICAL CORPORATION ” Practice Location

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