Organization
CUSTOM-EYES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN JOHN FULGIERI (OPTICIAN)
(727) 443-4011
Entity
Organization
Contact information
Practice address
1269 S MISSOURI AVE, CLEARWATER, FL 33756-4174
(727) 443-4011
Mailing address
1269 S MISSOURI AVE, CLEARWATER, FL 33756-4174
(727) 443-4011
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
2536
FL
Other
Enumeration date
11/28/2007
Last updated
01/22/2008
Update your record
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