Provider Demographics
NPI:1164958773
Name:PEEPERS EYECARE INC
Entity Type:Organization
Organization Name:PEEPERS EYECARE INC
Other - Org Name:HINDSIGHT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IBRAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-259-1621
Mailing Address - Street 1:2478 BURNSED BLVD #466A
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32163
Mailing Address - Country:US
Mailing Address - Phone:352-399-5412
Mailing Address - Fax:
Practice Address - Street 1:2478 BURNSED BLVD #466A
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163
Practice Address - Country:US
Practice Address - Phone:352-399-5412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEEPERS EYECARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO5201156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty