Provider Demographics
NPI:1538432661
Name:A1A OPTICS, INC.
Entity type:Organization
Organization Name:A1A OPTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:JOEEN
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:321-799-1222
Mailing Address - Street 1:237 W COCOA BEACH CSWY
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-3538
Mailing Address - Country:US
Mailing Address - Phone:321-799-1222
Mailing Address - Fax:321-799-1220
Practice Address - Street 1:237 W COCOA BEACH CSWY
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-3538
Practice Address - Country:US
Practice Address - Phone:321-799-1222
Practice Address - Fax:321-799-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO2482332H00000X
FLDO3137332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier