Provider Demographics
NPI:1285862912
Name:MNS OPTIX LLC
Entity Type:Organization
Organization Name:MNS OPTIX LLC
Other - Org Name:MIRAGE OPTICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEBOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-544-6924
Mailing Address - Street 1:22191 POWERLINE RD STE 26C
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5019
Mailing Address - Country:US
Mailing Address - Phone:561-544-6924
Mailing Address - Fax:561-544-6925
Practice Address - Street 1:22191 POWERLINE RD STE 26C
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5019
Practice Address - Country:US
Practice Address - Phone:561-544-6924
Practice Address - Fax:561-544-6925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO5895156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty