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Organization
REGENCY OPTICAL CORP
Active
Organization
REGENCY OPTICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILYA GINZBURG OD (PRESIDENT)
(267) 307-2098
Entity
Organization
Contact information
Practice address
4975 SW 148TH AVE, DAVIE, FL 33330-2419
(267) 307-2098
Mailing address
4975 SW 148TH AVE, DAVIE, FL 33330-2419
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
NULL
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
11/11/2019
Last updated
11/11/2019
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