Provider Demographics
NPI:1407147945
Name:ORION EYE CARE, LLC
Entity Type:Organization
Organization Name:ORION EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SARIVANNARA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:941-661-5903
Mailing Address - Street 1:8040 MEDITERRANEAN DR
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-8304
Mailing Address - Country:US
Mailing Address - Phone:239-390-2945
Mailing Address - Fax:239-390-3195
Practice Address - Street 1:8040 MEDITERRANEAN DR
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-8304
Practice Address - Country:US
Practice Address - Phone:239-390-2945
Practice Address - Fax:239-390-3195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4488152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty