Organization
SUPER OPTICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN LOPEZ (VICE-PRESIDENT)
(305) 821-7654
Entity
Organization
Contact information
Practice address
3805 W 16TH AVE, HIALEAH, FL 33012-7004
(305) 821-7654
Mailing address
3805 W 16TH AVE, HIALEAH, FL 33012-7004
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
—
—
Other
Enumeration date
06/14/2007
Last updated
08/22/2020
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