National Provider Identifier Database

OPTICAL OUTLET INC IV
Optician


Contact Information

OPTICAL OUTLET INC IV
319 SE PORT ST LUCIE BLVD
PORT SAINT LUCIE, FL34984
Phone: 772-878-1414
Fax: 772-878-0118
Website:
Specialty Taxonomy Code
* Optician 156FX1800X

* Indicates primary specialty

NPI Profile & details for OPTICAL OUTLET INC IV

NPI Number 1104046267
Legal business name
LBN
OPTICAL OUTLET INC IV
Authorized official LORRAINE ARTEAGA - (LICENSED OPTICIAN OWNER)
Entity Organization
Organization subpart No
Enumeration date 04/30/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: DO3422

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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