MEDICARE: VERDINO OPTICIANS INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	FL3876	FL

General Provider Information

NPI Number	:	1891935631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERDINO OPTICIANS INC.

Provider Business Mailing Address
First Line	:	5068 W ATLANTIC AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-8129
Country	:	US
Telephone Number	:	561-498-8884
Fax Number	:	561-498-7878

Provider Business Practice Location Address
First Line	:	5068 W ATLANTIC AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33484-8129
Country	:	US
Telephone Number	:	561-498-8884
Fax Number	:	561-498-7878

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RANDALL M MARTINELLI
Credential	:	L.D.O.
Telephone Number	:	561-498-8884

Provider Enumeration Date	:	03/05/2009
Last Update Date	:	10/13/2015

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