Organization
OPTICAL LABORATORY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARJORIE O. HAZOURI (MANAGER)
(352) 331-2727
Entity
Organization
Contact information
Practice address
618 SW 4TH AVE, GAINESVILLE, FL 32601-6429
(352) 376-5563
(352) 376-8783
Mailing address
618 SW 4TH AVE, GAINESVILLE, FL 32601-6429
(352) 376-5563
(352) 376-8783
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
29463
FL
Other
Enumeration date
02/20/2009
Last updated
03/17/2009
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