Organization
OPTICAL CITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLIVE LATTIBEAUDIERE (OPTICIAN/OWNER)
(954) 749-5881
Entity
Organization
Contact information
Practice address
10057B SUNSET STRIP, SUNRISE, FL 33322-5301
(954) 749-5881
Mailing address
10057B SUNSET STRIP, SUNRISE, FL 33322-5301
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
OE2143
FL
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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