| NPI | 1396858098 |
|---|---|
| Doing Business As | OPTICAL SHOP |
| Entity Type | Organization |
| Authorized Contact | MARK S. GOROVOY President 239-939-1444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: FL 840342) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2008-09-15 |