PRISON REHABILITATIVE INDUSTRIES DIVERSIFIED ENTERPRISES INC NPI 1659531309

NPI Information

PRISON REHABILITATIVE INDUSTRIES DIVERSIFIED ENTERPRISES, INC is an eyewear supplier in Ft Lauderdale, FL. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. PRISON REHABILITATIVE INDUSTRIES DIVERSIFIED ENTERPRISES, INC NPI is 1659531309. The provider is registered as an organization entity type.
The provider Other Name Is P.r.i.d.e Broward Optical.

The provider's business location address is:

20421 SHERIDAN ST
FT LAUDERDALE, FL
ZIP 33332-300
Phone: (800) 523-1766
Fax: (813) 890-2103

The provider's authorized official is Peter Radanovich .
The authorized official title is Chief Financial Officer and has the following contact phone number (727) 556-3370.

The enumeration date for this NPI number is 6/16/2008 and was last updated on 6/16/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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