Organization
EYEWEAR REPUBLIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DELL BENJAMIN WHITE O.D. (PRESIDENT)
(801) 808-5397
Entity
Organization
Contact information
Practice address
567 E SAMPLE RD, POMPANO BEACH, FL 33064-4425
(801) 808-5397
Mailing address
160 SW 117TH TER APT 104, PEMBROKE PINES, FL 33025-3491
(801) 808-5397
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4577
FL
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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