Provider Demographics
NPI:1477838696
Name:ESTEVEZ OPTICAL
Entity Type:Organization
Organization Name:ESTEVEZ OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:AMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTEVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:305-266-6949
Mailing Address - Street 1:7292 SW 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6632
Mailing Address - Country:US
Mailing Address - Phone:305-266-6949
Mailing Address - Fax:305-265-1139
Practice Address - Street 1:7292 SW 40TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6632
Practice Address - Country:US
Practice Address - Phone:305-266-6949
Practice Address - Fax:305-265-1139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty