Provider Demographics
NPI:1417180282
Name:MARC S.FLESHER O.D. P.A.
Entity Type:Organization
Organization Name:MARC S.FLESHER O.D. P.A.
Other - Org Name:EYE-SITE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:S
Authorized Official - Last Name:FLESHER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-738-0112
Mailing Address - Street 1:2244 N CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8604
Mailing Address - Country:US
Mailing Address - Phone:561-738-0112
Mailing Address - Fax:561-735-9359
Practice Address - Street 1:2244 N CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8604
Practice Address - Country:US
Practice Address - Phone:561-738-0112
Practice Address - Fax:561-735-9359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2274332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL086897300Medicaid
FLCB102AMedicare PIN
FL0765780001Medicare NSC