| Dr. Medina's Optical, Llc. | |
|
8247 Sw 124th St Pinecrest FL 33156-5900 | |
| (305) 233-1330 | |
| (305) 233-1362 |
| Full Name | Dr. Medina's Optical, Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 8247 Sw 124th St, Pinecrest, Florida |
| Authorized Official Name and Position | Ariel Medina (PRESIDENT) |
| Authorized Official Contact | 3052331330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Medina's Optical, Llc. 8247 Sw 124th St Pinecrest FL 33156-5900 Ph: (305) 233-1330 | Dr. Medina's Optical, Llc. 8247 Sw 124th St Pinecrest FL 33156-5900 Ph: (305) 233-1330 |
| NPI Number | 1205185469 |
|---|---|
| Provider Enumeration Date | 09/04/2012 |
| Last Update Date | 04/12/2013 |
| Medicare PECOS PAC ID | 3971749151 |
|---|---|
| Medicare Enrollment ID | O20130412000250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205185469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | OPC 4155 (Florida) | Primary |
| 332H00000X | Eyewear Supplier | OPC 4155 (Florida) | Secondary |
| Provider Name | Ariel Medina |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1316056336 PECOS PAC ID: 1557507621 Enrollment ID: I20130416000061 |
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