Provider Demographics
NPI:1750574067
Name:STYLE SITE OPTICIANS INC
Entity type:Organization
Organization Name:STYLE SITE OPTICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELBRAND
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:305-945-3361
Mailing Address - Street 1:1372 NE 163RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-4623
Mailing Address - Country:US
Mailing Address - Phone:305-945-3361
Mailing Address - Fax:305-945-3361
Practice Address - Street 1:1372 NE 163RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4623
Practice Address - Country:US
Practice Address - Phone:305-945-3361
Practice Address - Fax:305-945-3361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL086702100Medicaid
FL086702100Medicaid