1162 Military Trail LLC
Optometrist in Miami, FL. Organization (NPI-2).
NPI number1629489406
StatusActive
Last updated in NPPESMay 14, 2014
Details
- NPI
- 1629489406
- Entity type
- Organization (NPI-2)
- Legal business name
- 1162 Military Trail LLC
- Organization subpart
- No
- Enumeration date
- May 14, 2014
- Last updated
- May 14, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Other names
- Laser Eye Center Of Miami (Doing Business As)
Practice location
1661 Sw 37th AveSte. 102
Miami, FL 33145-1754
Phone 305-461-2400 · Fax 305-461-2902
Mailing address
1661 Sw 37th AveSte. 102
Miami, FL 33145-1754
Phone 305-461-2400 · Fax 305-461-2902
Authorized official
Galen Grayson
Medical Director/Owner
8778810022
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