| Organization Name: | DR. MEDINA'S OPTICAL, LLC. |
| NPI Number: | 1205185469 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ARIEL MEDINA (PRESIDENT) |
| Mailing Address: | 8247 Sw 124th St Pinecrest |
| State: | FL US |
| Postal Code: | 331565900 |
| Phone Number: | 3052331330 |
| Fax Number: | 3052331362 |
| NPI Enumeration Date: | 09/04/2012 |
| NPI Last Update Date: | 04/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | OPC 4155 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |