Provider Demographics
NPI:1558737163
Name:SUN GALLERY ENTERPRISES
Entity Type:Organization
Organization Name:SUN GALLERY ENTERPRISES
Other - Org Name:EYE ENVY OPTICAL AND SUNGLASSES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:SHARPE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:904-277-2779
Mailing Address - Street 1:463867 SR 200
Mailing Address - Street 2:SUITE 4
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097
Mailing Address - Country:US
Mailing Address - Phone:904-277-2779
Mailing Address - Fax:
Practice Address - Street 1:463867 SR 200
Practice Address - Street 2:SUITE 4
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097
Practice Address - Country:US
Practice Address - Phone:904-277-2779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOE 2033332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier