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:
Map and Directions
Authorized official contact:
Name: Radanovich, Peter
Phone: (727) 556-3370

Health care specialties

SpecialtyCodeLicense #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 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659531309 NPPES
Florida MEDICAID 086571100

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