Organization
EAGLE OPTICAL CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER WAYNE FREY LDO (PRESIDENT)
(813) 977-4801
Entity
Organization
Contact information
Practice address
1410 E FLETCHER AVE, TAMPA, FL 33612-3668
(813) 977-4801
Mailing address
1410 E FLETCHER AVE, TAMPA, FL 33612-3668
(813) 977-4801
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
DO 2954
FL
Other
Enumeration date
12/28/2007
Last updated
02/01/2008
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