Provider Demographics
NPI:1689894180
Name:BEAUTIFUL EYES INC.
Entity Type:Organization
Organization Name:BEAUTIFUL EYES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRU
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED OPTICIAN
Authorized Official - Phone:305-362-4020
Mailing Address - Street 1:801 W 49TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3555
Mailing Address - Country:US
Mailing Address - Phone:305-362-4020
Mailing Address - Fax:305-362-0091
Practice Address - Street 1:801 W 49TH ST STE 110
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3555
Practice Address - Country:US
Practice Address - Phone:305-362-4020
Practice Address - Fax:305-362-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO 2369156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty