Exclusive Eyewear No. 1, LLC
Optometrist in Plantation, FL. Organization (NPI-2).
NPI number1902400609
StatusActive
Last updated in NPPESFeb 19, 2021
Details
- NPI
- 1902400609
- Entity type
- Organization (NPI-2)
- Legal business name
- Exclusive Eyewear No. 1, LLC
- Organization subpart
- No
- Enumeration date
- Nov 24, 2020
- Certification date
- Feb 19, 2021
- Last updated
- Feb 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – |
Other names
- My Eyelab (Doing Business As)
Practice location
12233 W Sunrise BlvdPlantation, FL 33323-2234
Phone 954-824-2400 · Fax 561-828-8367
Mailing address
12233 W Sunrise BlvdPlantation, FL 33323-2234
Authorized official
Jackie Bennett
Credentialing Manager
5612752020
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