Provider Demographics
NPI:1831478643
Name:FOR EYES OPTICAL CO. OF COCONUT GROVE, FL
Entity Type:Organization
Organization Name:FOR EYES OPTICAL CO. OF COCONUT GROVE, FL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP., OF MANAGED VISION CARE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-292-4137
Mailing Address - Street 1:PO BOX 102472
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2472
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:285 W 74TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5058
Practice Address - Country:US
Practice Address - Phone:305-557-9004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARANON CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-10
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier