Provider Demographics
NPI:1114479714
Name:FABILENS CORP
Entity Type:Organization
Organization Name:FABILENS CORP
Other - Org Name:EXPRESS OPTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCO
Authorized Official - Middle Name:
Authorized Official - Last Name:ENCINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-228-7932
Mailing Address - Street 1:7450 NW 104TH AVE UNIT C103
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3360
Mailing Address - Country:US
Mailing Address - Phone:786-228-7932
Mailing Address - Fax:
Practice Address - Street 1:7450 NW 104TH AVE UNIT C103
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-3360
Practice Address - Country:US
Practice Address - Phone:786-228-7932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-29
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3384152W00000X
FLDO6821156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty