MEDICARE: OPTICAL OPTIONS 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	156FX1800X	Optician	SC.11195	OH

General Provider Information

NPI Number	:	1518388974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTICAL OPTIONS LLC.

Provider Business Mailing Address
First Line	:	4320 PEARL RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-4209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4320 PEARL RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-4209
Country	:	US
Telephone Number	:	216-772-7106
Fax Number	:

Authorized Official
Title or Position	:	LICENSED OPTICIAN OWNER
Name	:	JOSEPH COLINI
Credential	:	LICENSED OPTICIAN
Telephone Number	:	216-772-7106

Provider Enumeration Date	:	01/02/2014
Last Update Date	:	01/02/2014

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Directions to “OPTICAL OPTIONS LLC. ” Practice Location

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