Provider Demographics
NPI:1215421417
Name:THE OPTICAL PROFESSIONALS, LLC
Entity type:Organization
Organization Name:THE OPTICAL PROFESSIONALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDING
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:954-707-3800
Mailing Address - Street 1:790 NE 147TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-2363
Mailing Address - Country:US
Mailing Address - Phone:954-707-3800
Mailing Address - Fax:
Practice Address - Street 1:790 NE 147TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-2363
Practice Address - Country:US
Practice Address - Phone:954-707-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO-7010156FX1800X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty