Organization Name: | A & M BEACH OPTICAL |
NPI Number: | 1023178852 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RONALD MILLS (OWNER) |
Mailing Address: | 1155 Pasadena Ave S Suite B South Pasadena |
State: | FL US |
Postal Code: | 337072878 |
Phone Number: | 7273431521 |
Fax Number: | 7273432490 |
NPI Enumeration Date: | 12/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 2489 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |