| NPI | 1689449365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL MALDONADO President 939-640-0376 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2023-11-22 |
| Last Update Date | 2023-11-22 |