| NPI | 1912601345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL GARZA Managed Care Manager 561-275-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-03-29 |