Provider Demographics
NPI:1306020607
Name:SANMAR OPTICAL INC.
Entity Type:Organization
Organization Name:SANMAR OPTICAL INC.
Other - Org Name:EYE OPTICS OF MIAMI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICIAN/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-932-2020
Mailing Address - Street 1:20335 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 25
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1503
Mailing Address - Country:US
Mailing Address - Phone:305-932-2020
Mailing Address - Fax:305-932-1948
Practice Address - Street 1:20335 BISCAYNE BLVD
Practice Address - Street 2:SUITE 25
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1503
Practice Address - Country:US
Practice Address - Phone:305-932-2020
Practice Address - Fax:305-932-1948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO2381332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0980200001OtherMEDICARE