| |
8485 Sw 40th St, Suite 103, Miami, FL 33155-3244 | |
(305) 223-6142 | |
(305) 552-0824 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 8485 Sw 40th St, Miami, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861797482 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | OE879 (Florida) | Primary |
Mailing Address | Practice Location Address |
---|---|
8485 Sw 40th St, Suite 103, Miami, FL 33155-3244 Ph: (305) 223-6142 | 8485 Sw 40th St, Suite 103, Miami, FL 33155-3244 Ph: (305) 223-6142 |