Provider Demographics
NPI:1437643343
Name:MITTLEMAN EYE CENTER PA
Entity Type:Organization
Organization Name:MITTLEMAN EYE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:
Authorized Official - Last Name:GLATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-500-2020
Mailing Address - Street 1:2000 PALM BEACH LAKES BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6504
Mailing Address - Country:US
Mailing Address - Phone:561-500-2020
Mailing Address - Fax:561-478-1300
Practice Address - Street 1:601 UNIVERSITY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2788
Practice Address - Country:US
Practice Address - Phone:561-500-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MITTLEMAN EYE CENTER PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-15
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty