Provider Demographics
NPI:1346809480
Name:MOBILE OPTIX PLLC
Entity Type:Organization
Organization Name:MOBILE OPTIX PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GISELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-708-1289
Mailing Address - Street 1:442 W KENNEDY BLVD STE 320
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-1411
Mailing Address - Country:US
Mailing Address - Phone:813-708-1289
Mailing Address - Fax:813-708-5513
Practice Address - Street 1:442 W KENNEDY BLVD STE 320
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-1411
Practice Address - Country:US
Practice Address - Phone:813-708-1289
Practice Address - Fax:813-708-5513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty