Provider Demographics
NPI:1598564502
Name:COSMIC CONTACT LENSES AND GLASSES LLC
Entity type:Organization
Organization Name:COSMIC CONTACT LENSES AND GLASSES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER LICENSED OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMODOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-206-0476
Mailing Address - Street 1:2761 NW FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-9258
Mailing Address - Country:US
Mailing Address - Phone:561-800-4066
Mailing Address - Fax:
Practice Address - Street 1:2761 NW FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-9258
Practice Address - Country:US
Practice Address - Phone:561-800-4066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens FitterGroup - Multi-Specialty