MEDICARE: ONIX OPTICAL CENTER

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	DO2805	FL

General Provider Information

NPI Number	:	1548333230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONIX OPTICAL CENTER

Provider Business Mailing Address
First Line	:	PO BOX 4064
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-0064
Country	:	US
Telephone Number	:	305-824-1448
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 W 84TH ST
Second Line	:	SUITE 15
City	:	HIALEAH
State	:	FL
Zip	:	33014-3377
Country	:	US
Telephone Number	:	305-824-1448
Fax Number	:

Authorized Official
Title or Position	:	OPTICIAN
Name	:	MR. LUIS HERNAN MAYORGA
Credential	:
Telephone Number	:	305-824-1448

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	08/22/2020

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Directions to “ONIX OPTICAL CENTER ” Practice Location

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