| NPI | 1659371714 |
|---|---|
| Other Name | OPTICAL SHOP |
| Entity Type | Organization |
| Authorized Contact | THOMAS LLOYD CROLEY Medical Director 352-237-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL ME0048124) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2020-08-22 |