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Organization

EXCLUSIVE EYEWEAR NO. 1, LLC

Active
Other names
My EyeLab
Organization subpart
No

Provider details

NPI number
Authorized official
JACKIE BENNETT (CREDENTIALING MANAGER)
(561) 275-2020
Entity
Organization

Contact information

Practice address
12233 W SUNRISE BLVD, PLANTATION, FL 33323-2234
(954) 824-2400
(561) 828-8367
Mailing address
12233 W SUNRISE BLVD, PLANTATION, FL 33323-2234

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Enumeration date
12/01/2020
Last updated
02/19/2021
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