Cabana Eyes Optical

NPI #1154867554 in Crestview, Florida

Provider Information

NPI Number: 1154867554
Entity Type: Organization
Organization Name: Cabana Eyes Optical
Subpart: Yes (part of a larger organization)
Parent Organization: EDWARD MITCHELL JR
Primary Specialty: Eyewear Supplier
Enumeration Date: Jan 10, 2017
Last Updated: Oct 23, 2019

Practice Location

Address: 4100 S FERDON BLVD
Address 2: SUITE B5
City: Crestview
State: Florida
ZIP Code: 32536-5252
Phone: (850) 758-0474

Authorized Official

Name: MR. EDWARD MITCHELL JR., LDO
Title: OWNER/ VISUAL RESOURCE DIRECTOR
Phone: (850) 758-0474

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Medical Specialty — Medical Specialty	261QM2500X
Eyewear Supplier	332H00000X	Primary

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MR. Edward Mitchell JR., LDO	Eyewear Supplier	Crestview	AI Deep Dive

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