Provider Demographics
NPI:1164516324
Name:DELRAY EYE ASSOCIATES PA
Entity Type:Organization
Organization Name:DELRAY EYE ASSOCIATES PA
Other - Org Name:PRECISION EYEWEAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-214-0144
Mailing Address - Street 1:16201 S MILITARY TRL
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6503
Mailing Address - Country:US
Mailing Address - Phone:561-498-8100
Mailing Address - Fax:561-498-8188
Practice Address - Street 1:16201 MILITARY TRL
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6503
Practice Address - Country:US
Practice Address - Phone:561-498-8100
Practice Address - Fax:561-498-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0920450001Medicare NSC