Provider Demographics
NPI:1356949630
Name:HOME OPTICAL GROUP INC
Entity type:Organization
Organization Name:HOME OPTICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:RAQUEL
Authorized Official - Last Name:BARRIENTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-861-0018
Mailing Address - Street 1:6989 COLLINS AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-3205
Mailing Address - Country:US
Mailing Address - Phone:305-861-0018
Mailing Address - Fax:305-861-0017
Practice Address - Street 1:6989 COLLINS AVE
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-3205
Practice Address - Country:US
Practice Address - Phone:305-861-0018
Practice Address - Fax:305-861-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty