| NPI | 1215798301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITZANIA POLANCO Secretary/Optician 786-564-2439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 156FC0800X Technician/Technologist, Contact Lens | |
| 156FC0801X Technician/Technologist, Contact Lens Fitter | |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2024-01-18 |