Provider Demographics
NPI:1396917597
Name:E.SABATES OPTICAL SERVICE INC.
Entity type:Organization
Organization Name:E.SABATES OPTICAL SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:N
Authorized Official - Last Name:SABATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-888-0005
Mailing Address - Street 1:2900 W 12TH AVE
Mailing Address - Street 2:SUITE # 5
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4860
Mailing Address - Country:US
Mailing Address - Phone:305-888-0005
Mailing Address - Fax:305-888-0006
Practice Address - Street 1:2900 W 12TH AVE
Practice Address - Street 2:SUITE # 5
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4860
Practice Address - Country:US
Practice Address - Phone:305-888-0005
Practice Address - Fax:305-888-0006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO1132156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL086022100Medicaid
FL0873590001Medicare NSC