Organization
2010 OPTICAL PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENRIQUE LOPEZ (OPTICIAN)
(786) 373-6025
Entity
Organization
Contact information
Practice address
5645 NW 87TH AVE STE 100, DORAL, FL 33178-2182
(786) 373-6025
Mailing address
5645 NW 87TH AVE STE 100, DORAL, FL 33178-2182
(786) 373-6025
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
63014900
—
FL
Enumeration date
05/16/2024
Last updated
04/02/2026
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