Provider Demographics
NPI:1285845008
Name:LA SALLE OPTICAL CORP
Entity Type:Organization
Organization Name:LA SALLE OPTICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:AURORA
Authorized Official - Last Name:ARCINIEGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-316-8245
Mailing Address - Street 1:10000 SW 56TH ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7165
Mailing Address - Country:US
Mailing Address - Phone:305-598-5554
Mailing Address - Fax:305-598-5554
Practice Address - Street 1:10000 SW 56TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7165
Practice Address - Country:US
Practice Address - Phone:305-598-5554
Practice Address - Fax:305-598-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier