# REGENCY OPTICAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184269433
- **Authorized official:** ILYA GINZBURG OD (PRESIDENT)
- **Authorized official phone:** (267) 307-2098

## Contact information

- **Practice address:** 4975 SW 148TH AVE, DAVIE, FL 33330-2419
- **Practice address phone:** (267) 307-2098
- **Mailing address:** 4975 SW 148TH AVE, DAVIE, FL 33330-2419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 11/11/2019
- **Last updated:** 11/11/2019