Organization
FOR EYES OPTICAL COMPANY OF PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE COSTA (CEO)
(305) 557-9004
Entity
Organization
Contact information
Practice address
240 ANDOVER ST STE A, PEABODY, MA 01960-1537
(305) 557-9004
Mailing address
3601 SW 160TH AVE STE 400, MIRAMAR, FL 33027-6312
(305) 557-9004
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
09/17/2018
Last updated
09/17/2018
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