Provider Demographics
NPI:1376646570
Name:ALLAN'S OPTICAL & LABORATORY
Entity Type:Organization
Organization Name:ALLAN'S OPTICAL & LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-591-0027
Mailing Address - Street 1:3399 NW 72ND AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1349
Mailing Address - Country:US
Mailing Address - Phone:305-591-0027
Mailing Address - Fax:305-591-3355
Practice Address - Street 1:3399 NW 72ND AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33122-1349
Practice Address - Country:US
Practice Address - Phone:305-591-0027
Practice Address - Fax:305-591-3355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO5411156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty