Provider Demographics
NPI:1033487988
Name:EYETRUST VISION
Entity Type:Organization
Organization Name:EYETRUST VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRYCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-587-9898
Mailing Address - Street 1:1201 BRICKELL AVE
Mailing Address - Street 2:300
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1201 BRICKELL AVE
Practice Address - Street 2:300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-3207
Practice Address - Country:US
Practice Address - Phone:305-587-9898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4514152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty