Provider Demographics
NPI:1164634291
Name:PBO ENTERPRISES INC.
Entity Type:Organization
Organization Name:PBO ENTERPRISES INC.
Other - Org Name:PEREZ-BLANCO OPHTHALMOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:C
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ-BLANCO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-858-4500
Mailing Address - Street 1:2345 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145
Mailing Address - Country:US
Mailing Address - Phone:305-858-4500
Mailing Address - Fax:305-858-8999
Practice Address - Street 1:2345 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145
Practice Address - Country:US
Practice Address - Phone:305-858-4500
Practice Address - Fax:305-858-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3378152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty