Organization Name: | EYEGLASS WORLD |
NPI Number: | 1235498932 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN EDICK (MC ASST) |
Mailing Address: | 2109 66th Street N. St. Petersburg |
State: | FL US |
Postal Code: | 33710 |
Phone Number: | 7273425226 |
Fax Number: | 7273425231 |
NPI Enumeration Date: | 05/15/2012 |
NPI Last Update Date: | 05/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |