Provider Demographics
NPI:1912617697
Name:T AND T OPTICAL
Entity type:Organization
Organization Name:T AND T OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GEORGINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GRANADOS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-586-0698
Mailing Address - Street 1:553A E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4549
Mailing Address - Country:US
Mailing Address - Phone:305-887-1035
Mailing Address - Fax:305-889-5941
Practice Address - Street 1:553A E 9TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4549
Practice Address - Country:US
Practice Address - Phone:305-887-1035
Practice Address - Fax:305-889-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier