Provider Demographics
NPI:1902047681
Name:ALL EYES OPTICAL
Entity Type:Organization
Organization Name:ALL EYES OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VITO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-683-9678
Mailing Address - Street 1:13688 W STATE ROAD 84
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-5302
Mailing Address - Country:US
Mailing Address - Phone:954-452-0999
Mailing Address - Fax:954-452-3076
Practice Address - Street 1:13688 W STATE ROAD 84
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33325-5302
Practice Address - Country:US
Practice Address - Phone:954-452-0999
Practice Address - Fax:954-452-3076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3007332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier