1162 Military Trail LLC
NPI 1750638755ActiveOrganization· Technician/Technologist, Optician· Santa Rosa Beach, FL
Technician/Technologist, Optician in Santa Rosa Beach, Florida, registered in NPPES in August 2012. The authorized official on file is Galen Grayson, M.D., Owner/Medical Director.
Overview
| NPI | 1750638755 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 8, 2012 |
| Last updated in NPPES | Aug 8, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Technician/Technologist, Optician Primary | 156FX1800X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|