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Organization
OPTIC PLANET LLC
Active
Organization
OPTIC PLANET LLC
Active
Other names
Mauri eye associates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DENISE MARTIN (BILLER)
(305) 821-0304
Entity
Organization
Contact information
Practice address
15332 NW 79TH CT, MIAMI LAKES, FL 33016-5808
(305) 821-0304
(305) 558-0641
Mailing address
15332 NW 79TH CT, MIAMI LAKES, FL 33016-5808
(305) 821-0304
(305) 558-0641
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
NULL
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285159178
NPI
FL
01
—
1669133625
NPI
FL
01
—
1811144850
NPI
FL
Enumeration date
07/25/2023
Last updated
07/26/2023
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