P.R.I.D.E Broward Optical
LBN: Prison Rehabilitative Industries Diversified Enterprises, Inc
P.R.I.D.E Broward Optical is an health care organization with primary practice located at 20421 Sheridan St , Ft Lauderdale FL 33332-2300. The organization recently has only one registered license in Suppliers / Eyewear Supplier (Equipment, not the service), which is considered as the primary health care specialty.
Prison Rehabilitative Industries Diversified Enterprises, Inc can be contacted via phone (800) 523-1766, or through Radanovich, Peter via phone (727) 556-3370.
Contact Information
Primary practice address
20421 Sheridan St
Ft Lauderdale FL 33332-2300
Phone: (800) 523-1766
Fax: (813) 890-2103
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Eyewear Supplier (Equipment, not the service) | 332H00000X | S. 2220 | Ohio |
Profile Details
| NPI number | 1659531309 |
|---|---|
| LBN Legal business name | Prison Rehabilitative Industries Diversified Enterprises, Inc |
| DBA Doing business as | P.R.I.D.E Broward Optical |
| Authorized official | Radanovich, Peter |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 16th, 2008 |
| Last updated | Jun 16th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659531309 | NPPES |
| Florida | MEDICAID | 086571100 |
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