Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 3846 | FL |
NPI | 1104339894 |
---|---|
Provider Name | Ms. Irma Sanchez |
First Address | Miami, FL 33186-1707 |
Second Address | Miami, FL 33186-1707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2017 |
Last Update Date | 16/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
811418581 | SPECTERA, DAVIS VISION, EYEMED, VSP, SUPERIOR VISION (01) | FL |
811418581 | SPECTERA, VSP, EYEMED, SUPERIOR VISON (01) | FL |