Provider Demographics
NPI:1831425834
Name:FLORIDA OPTICAL EXPRESS
Entity type:Organization
Organization Name:FLORIDA OPTICAL EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-864-7776
Mailing Address - Street 1:160 BOSTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4706
Mailing Address - Country:US
Mailing Address - Phone:407-834-7776
Mailing Address - Fax:407-834-0973
Practice Address - Street 1:160 BOSTON AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4706
Practice Address - Country:US
Practice Address - Phone:407-834-7776
Practice Address - Fax:407-834-0973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier