Provider Demographics
NPI:1285231423
Name:INNOVATION EYE CARE LLC
Entity Type:Organization
Organization Name:INNOVATION EYE CARE LLC
Other - Org Name:INNOVATION EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIGROD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-850-3993
Mailing Address - Street 1:11622 STEIN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6363
Mailing Address - Country:US
Mailing Address - Phone:954-850-3993
Mailing Address - Fax:
Practice Address - Street 1:19475 BOGGY CREEK RD STE B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-7000
Practice Address - Country:US
Practice Address - Phone:954-850-3993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty