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Organization

OPTICAL OUTLET INC IV

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORRAINE O ARTEAGA (LICENSED OPTICIAN OWNER)
(772) 878-1414
Entity
Organization

Contact information

Practice address
319 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34984
(772) 878-1414
(772) 878-0118
Mailing address
319 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34984
(772) 878-1414
(772) 878-0118

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO3422
FL

Other

Enumeration date
04/30/2007
Last updated
08/22/2020
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