Provider Demographics
NPI:1407925563
Name:NORTH RIDGE OPTICAL, INC.
Entity Type:Organization
Organization Name:NORTH RIDGE OPTICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCIARRINO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-771-9889
Mailing Address - Street 1:5601 N DIXIE HWY STE 115
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4144
Mailing Address - Country:US
Mailing Address - Phone:954-771-9889
Mailing Address - Fax:954-776-5959
Practice Address - Street 1:5601 N DIXIE HWY STE 115
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-4144
Practice Address - Country:US
Practice Address - Phone:954-771-9889
Practice Address - Fax:954-776-5959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO 4651156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0568190001Medicare NSC