Provider Demographics
NPI:1679995443
Name:DISCOUNT EYEGLASSES
Entity Type:Organization
Organization Name:DISCOUNT EYEGLASSES
Other - Org Name:FABRICA DE ESPEJUELOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROERME
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:305-545-8432
Mailing Address - Street 1:1100 W FLAGLER ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1034
Mailing Address - Country:US
Mailing Address - Phone:305-545-8432
Mailing Address - Fax:305-545-8586
Practice Address - Street 1:1100 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1034
Practice Address - Country:US
Practice Address - Phone:305-545-8432
Practice Address - Fax:305-545-8586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO2429156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL086857400Medicaid