# OPTICAL OUTFITTERS, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1922497916
- **Authorized official:** CATHERINE YAECKEL O.D (OPTOMETRIST)
- **Authorized official phone:** (813) 645-2022

## Contact information

- **Practice address:** 242 HARBOR VILLAGE LN, APOLLO BEACH, FL 33572-3424
- **Practice address phone:** (813) 645-2022
- **Mailing address:** 242 HARBOR VILLAGE LN, APOLLO BEACH, FL 33572-3424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC4515 | FL | Yes |

## Other

- **Enumeration date:** 01/14/2015
- **Last updated:** 07/15/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002695100 | — | FL |
| 01 | — | DP715Z | MEDICARE PROVIDER NUMBER | FL |