Provider Demographics
NPI:1376675140
Name:CORNEA & REFRACTIVE CONSULTANTS OF THE PALM BEACHES, PA
Entity Type:Organization
Organization Name:CORNEA & REFRACTIVE CONSULTANTS OF THE PALM BEACHES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:KUHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-624-7878
Mailing Address - Street 1:11020 RCA CENTER DR
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4277
Mailing Address - Country:US
Mailing Address - Phone:561-624-7878
Mailing Address - Fax:561-626-5848
Practice Address - Street 1:11020 RCA CENTER DR
Practice Address - Street 2:SUITE 2001
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4277
Practice Address - Country:US
Practice Address - Phone:561-624-7878
Practice Address - Fax:561-626-5848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67968207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL180041947OtherRAILROAD MEDICARE
FL28414OtherBLUE CROSS BLUE SHIELD
FL7316412OtherAETNA
FL095565401OtherCIGNA
FL28414OtherBLUE CROSS BLUE SHIELD
FL28414OtherBLUE CROSS BLUE SHIELD
FLE23758Medicare UPIN