Provider Demographics
NPI:1245765205
Name:CAPSTONE EYE CARE GROUP OF FLORIDA LLC
Entity Type:Organization
Organization Name:CAPSTONE EYE CARE GROUP OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-317-2140
Mailing Address - Street 1:510 E MEMORIAL RD
Mailing Address - Street 2:SUITE A-4
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-2229
Mailing Address - Country:US
Mailing Address - Phone:405-445-1588
Mailing Address - Fax:
Practice Address - Street 1:7855 113TH ST BLDG P-2
Practice Address - Street 2:SUITE A
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772
Practice Address - Country:US
Practice Address - Phone:405-445-1588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier