Provider Demographics
NPI:1598145716
Name:GABLES OPTICAL SERVICES, INC
Entity Type:Organization
Organization Name:GABLES OPTICAL SERVICES, INC
Other - Org Name:SABATES OPTICL SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER.OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:SABATES
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:305-442-4422
Mailing Address - Street 1:1712 SW 57TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2137
Mailing Address - Country:US
Mailing Address - Phone:305-442-4422
Mailing Address - Fax:305-442-0770
Practice Address - Street 1:1712 SW 57TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2137
Practice Address - Country:US
Practice Address - Phone:305-442-4422
Practice Address - Fax:305-442-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0741332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL086862100Medicaid