Optica Latina, LLC

NPI #1992042972 in Lilburn, Georgia

Provider Information

NPI Number: 1992042972
Entity Type: Organization
Organization Name: Optica Latina, LLC
Primary Specialty: Optometrist
Enumeration Date: Jan 10, 2013
Last Updated: Jan 10, 2013

Practice Location

Address: 4485 LAWRENCEVILLE HWY NW
Address 2: SUITE 206
City: Lilburn
State: Georgia
ZIP Code: 30047-3669
Phone: (770) 674-1712

Authorized Official

Name: LEONEL E COELLO, LDO
Title: OWNER
Phone: (770) 815-1915

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician/Technologist - Optician — Optician	156FX1800X
Optometrist	152W00000X	Primary

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