| NPI | 1104585835 | 
|---|---|
| Doing Business As | MY EYELAB | 
| Entity Type | Organization | 
| Authorized Contact | DANIEL GARZA Managed Care Director 561-720-6423  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) | 
| Additional Taxonomies | 152W00000X Optometrist | 
| Enumeration Date | 2021-12-09 | 
| Last Update Date | 2021-12-09 |