| NPI | 1750833919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY CLARIK Chief Executive Officer 786-441-8471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2016-11-03 |