Provider Demographics
NPI:1174849806
Name:BK OPTICAL OF SARASOTA INC
Entity Type:Organization
Organization Name:BK OPTICAL OF SARASOTA INC
Other - Org Name:EYEGLASS WORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KARR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-359-6622
Mailing Address - Street 1:5265 UNIVERSITY PKWY
Mailing Address - Street 2:UNIT 101
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34201-3000
Mailing Address - Country:US
Mailing Address - Phone:941-359-6622
Mailing Address - Fax:941-359-8733
Practice Address - Street 1:5265 UNIVERSITY PKWY
Practice Address - Street 2:UNIT 101
Practice Address - City:UNIVERSITY PARK
Practice Address - State:FL
Practice Address - Zip Code:34201-3000
Practice Address - Country:US
Practice Address - Phone:941-359-6622
Practice Address - Fax:941-359-8733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO5419332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier