Provider Demographics
NPI:1750567830
Name:MJ & E CORPORATION
Entity type:Organization
Organization Name:MJ & E CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-574-0755
Mailing Address - Street 1:1730 W HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-1531
Mailing Address - Country:US
Mailing Address - Phone:954-574-0755
Mailing Address - Fax:954-574-9198
Practice Address - Street 1:1730 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-1531
Practice Address - Country:US
Practice Address - Phone:954-574-0755
Practice Address - Fax:954-574-9198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1560332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0959250001Medicare NSC