Provider Demographics
NPI:1043706138
Name:QUACHLE LLC
Entity Type:Organization
Organization Name:QUACHLE LLC
Other - Org Name:THE EYE PLACE OF HAMLIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATIENT CARE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-876-1200
Mailing Address - Street 1:6526 OLD BRICK RD STE 120-313
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-5839
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15996 NEW INDEPENDENCE PARKWAY
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787
Practice Address - Country:US
Practice Address - Phone:407-872-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1922070028OtherINDIVIDUAL NPI
1013103563OtherINDIVIDUAL NPI
1790934529OtherINDIVIDUAL NPI