Provider Demographics
NPI:1275705329
Name:COLLEGE OPTICAL EXPRESS FL INC.
Entity Type:Organization
Organization Name:COLLEGE OPTICAL EXPRESS FL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED MASTER OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:FEROCE
Authorized Official - Suffix:
Authorized Official - Credentials:MASTER OPTICIAN
Authorized Official - Phone:407-823-4020
Mailing Address - Street 1:4000 CENTRAL FLORIDA BLVD
Mailing Address - Street 2:SUITE 102 G
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32816-8005
Mailing Address - Country:US
Mailing Address - Phone:407-823-4020
Mailing Address - Fax:407-823-4008
Practice Address - Street 1:4000 CENTRAL FLORIDA BLVD
Practice Address - Street 2:SUITE 102 G
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32816-8005
Practice Address - Country:US
Practice Address - Phone:407-823-4020
Practice Address - Fax:407-823-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO 4961332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier