Provider Demographics
NPI:1023184363
Name:LANDA & LANDA EYE CARE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:LANDA & LANDA EYE CARE SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:LANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-355-1091
Mailing Address - Street 1:8 STEPHENSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5802
Mailing Address - Country:US
Mailing Address - Phone:912-355-1091
Mailing Address - Fax:912-352-7378
Practice Address - Street 1:8 STEPHENSON AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5802
Practice Address - Country:US
Practice Address - Phone:912-355-1091
Practice Address - Fax:912-352-7378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7600Medicare ID - Type Unspecified