Organization
DESIGNER COLLECTION OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MITZANIA POLANCO DO6785 (SECRETARY/OPTICIAN)
(786) 564-2439
Entity
Organization
Contact information
Practice address
15470 NW 77TH CT, MIAMI LAKES, FL 33016-5823
(786) 564-2439
Mailing address
15470 NW 77TH CT, MIAMI LAKES, FL 33016-5823
(786) 564-2439
Taxonomy
Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
—
—
156FC0801X
Contact Lens Fitter
—
—
156FX1800X
Optician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
01/17/2024
Last updated
01/18/2024
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