Organization
LIFETIME VISON AND EYE CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN J THAYIL OD (PRESIDENT)
(954) 600-5975
Entity
Organization
Contact information
Practice address
1600 SW 78TH AVE, APT 422, PLANTATION, FL 33324-3392
(954) 600-5975
Mailing address
1600 SW 78TH AVE, APT 422, PLANTATION, FL 33324-3392
(954) 600-5975
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4836
FL
Other
Enumeration date
05/01/2016
Last updated
05/01/2016
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