Organization
THE EYEGLASS PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISSETTE RAKUSA L.D.O. (PRESIDENT/OPTTICIAN)
(305) 669-3890
Entity
Organization
Contact information
Practice address
430 S DIXIE HWY, SUITE #5, CORAL GABLES, FL 33146-2273
(305) 669-3890
(305) 669-3935
Mailing address
430 S. DIXIE HWY, SUITE #5, CORAL GABLES, FL 33146-2273
(305) 669-3890
(305) 669-3935
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
OE1503
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
630399400
—
FL
Enumeration date
12/20/2007
Last updated
05/05/2009
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