MEDICARE: GLASSES RX, LLC

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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1457860371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLASSES RX, LLC

Provider Business Mailing Address
First Line	:	1360 E VENICE AVE
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34285-9066
Country	:	US
Telephone Number	:	941-488-2020
Fax Number	:	941-484-2200

Provider Business Practice Location Address
First Line	:	1236 JACARANDA BLVD
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-4507
Country	:	US
Telephone Number	:	941-496-4444
Fax Number	:	941-496-4223

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	MR. MICHAEL KRISZTINA AMES
Credential	:
Telephone Number	:	941-233-5802

Provider Enumeration Date	:	09/22/2017
Last Update Date	:	01/26/2024

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Directions to “GLASSES RX, LLC ” Practice Location

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