Provider Demographics
NPI:1164846911
Name:PABLO ROSEMBERG LLC
Entity Type:Organization
Organization Name:PABLO ROSEMBERG LLC
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSEMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-354-3939
Mailing Address - Street 1:5447 INTERNATIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8567
Mailing Address - Country:US
Mailing Address - Phone:407-248-8334
Mailing Address - Fax:407-248-8338
Practice Address - Street 1:5447 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8567
Practice Address - Country:US
Practice Address - Phone:407-248-8334
Practice Address - Fax:407-248-8338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOE2046332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier