Organization
BIRD ROAD OPTICAL, INC.
Active
Other names
De Vista Optical
Organization subpart
No
Provider details
NPI number
Authorized official
DORA REYES (OWNER)
(305) 223-6142
Entity
Organization
Contact information
Practice address
8485 SW 40TH ST, SUITE 103, MIAMI, FL 33155-3244
(305) 223-6142
(305) 552-0824
Mailing address
8485 SW 40TH ST, SUITE 103, MIAMI, FL 33155-3244
(305) 223-6142
(305) 552-0824
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
OE879
FL
Other
Enumeration date
01/12/2011
Last updated
12/09/2011
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