Provider Demographics
NPI:1306408075
Name:REFRACTIONISTAS
Entity Type:Organization
Organization Name:REFRACTIONISTAS
Other - Org Name:EYES ON LAKELAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ORNELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALUWIESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-250-5553
Mailing Address - Street 1:1400 S FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-2257
Mailing Address - Country:US
Mailing Address - Phone:954-558-1152
Mailing Address - Fax:
Practice Address - Street 1:1400 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-2257
Practice Address - Country:US
Practice Address - Phone:954-558-1152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty