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Exclusive Eyewear No. 1, LLC

Eyewear Supplier (Equipment, not the service) in Plantation, FL. Organization (NPI-2).

NPI number1316542210
StatusActive
Last updated in NPPESFeb 19, 2021

Details

NPI
1316542210
Entity type
Organization (NPI-2)
Legal business name
Exclusive Eyewear No. 1, LLC
Organization subpart
No
Enumeration date
Dec 1, 2020
Certification date
Feb 19, 2021
Last updated
Feb 19, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332H00000X Eyewear Supplier (Equipment, not the service)––Yes

Other names

  • My Eyelab (Doing Business As)

Practice location

12233 W Sunrise Blvd
Plantation, FL 33323-2234

Phone 954-824-2400 · Fax 561-828-8367

Mailing address

12233 W Sunrise Blvd
Plantation, FL 33323-2234

Authorized official

Jackie Bennett
Credentialing Manager
5612752020

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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