Optical Boutique INC.
Eyewear Supplier (Equipment, not the service) in Miami, FL. Organization (NPI-2).
NPI number1497954697
StatusActive
Last updated in NPPESJul 18, 2019
Details
- NPI
- 1497954697
- Entity type
- Organization (NPI-2)
- Legal business name
- Optical Boutique INC.
- Organization subpart
- No
- Enumeration date
- Jul 17, 2007
- Last updated
- Jul 18, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – | Yes |
| 156FX1800X | Technician/Technologist, Optician | DO2329 | FL |
Practice location
901 Nw 17th StSuite P
Miami, FL 33136-1135
Phone 305-324-0490 · Fax 305-324-9890
Mailing address
901 Nw 17th StSuite P
Miami, FL 33136-1135
Phone 305-324-0490 · Fax 305-324-9890
Authorized official
Juan Carlos Farias
Owner
3053240490
Is something wrong?
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