Provider Demographics
NPI:1447626171
Name:COHEN FASHION OPTICAL, LLC
Entity type:Organization
Organization Name:COHEN FASHION OPTICAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-413-4186
Mailing Address - Street 1:8000 W BROWARD BLVD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33388-0024
Mailing Address - Country:US
Mailing Address - Phone:954-472-4777
Mailing Address - Fax:954-472-1555
Practice Address - Street 1:8000 W BROWARD BLVD
Practice Address - Street 2:SUITE 135
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33388-0024
Practice Address - Country:US
Practice Address - Phone:954-472-4777
Practice Address - Fax:954-472-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1350332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier