Organization
FIRST IMAGE OPTICAL LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE L NEAL (PRESIDENT)
(469) 214-0144
Entity
Organization
Contact information
Practice address
5743 WILLIAMSBURG LN, WILDWOOD, FL 34785-8129
(352) 744-7002
Mailing address
17562 US HIGHWAY 441, MOUNT DORA, FL 32757-6711
(352) 735-2020
(352) 735-5187
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
03/27/2017
Last updated
02/05/2020
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