Organization
MAXIM-EYES OPTICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DULCIE KIFFNER (PRESIDENT)
(813) 653-9661
Entity
Organization
Contact information
Practice address
2547 E STATE ROAD 60, VALRICO, FL 33594-3830
(813) 653-9661
(813) 657-4334
Mailing address
2547 E STATE ROAD 60, VALRICO, FL 33594-3830
(813) 653-9661
(813) 657-4334
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC2050
FL
156FX1800X
Optician
Primary
DO4868
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078763900
—
FL
05
—
630341200
—
FL
Enumeration date
12/11/2014
Last updated
12/11/2014
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