Organization · NPI-2

1162 Military Trail LLC

Ophthalmology · Miami, FL

NPI number1962748244
StatusActive
Last updated in NPPESDec 14, 2012

Details

NPI
1962748244
Entity type
Organization (NPI-2)
Legal business name
1162 Military Trail LLC
Organization subpart
No
Enumeration date
Dec 14, 2012
Last updated
Dec 14, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207W00000X Ophthalmology–FLYes
152W00000X Optometrist–FL

Other names

  • The Eye Gallery-Miami (Doing Business As)

Practice location

1661 Sw 37th Ave
#102
Miami, FL 33145-1754

Phone 305-774-0891 · Fax 305-774-0894

Mailing address

8076 W Sahara Ave
Las Vegas, NV 89117-7930

Phone 877-881-0022 · Fax 702-543-0314

Authorized official

Erica Perreira
Chief Operating Officer
8778810022

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