Provider Demographics
NPI:1851539571
Name:YUNY OPTICAL MANUFACTURER INC
Entity Type:Organization
Organization Name:YUNY OPTICAL MANUFACTURER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-788-5650
Mailing Address - Street 1:5207 W 24TH WAY
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-4007
Mailing Address - Country:US
Mailing Address - Phone:305-231-2035
Mailing Address - Fax:305-231-2105
Practice Address - Street 1:5207 WEST 24 AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016
Practice Address - Country:US
Practice Address - Phone:305-231-2035
Practice Address - Fax:305-231-2105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO4898156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty