| NPI | 1700379385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK VINCENT MANDESE Owner 407-234-5788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: FL DO3019) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-08-10 |