Provider Demographics
NPI:1477700029
Name:FLORIDA EYE AND LASER CENTER INC.
Entity Type:Organization
Organization Name:FLORIDA EYE AND LASER CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAVKUMAR
Authorized Official - Middle Name:HARIKRISHNA
Authorized Official - Last Name:PANCHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-942-3937
Mailing Address - Street 1:2001 N FEDERAL HWY
Mailing Address - Street 2:STE.#206
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1030
Mailing Address - Country:US
Mailing Address - Phone:954-942-3937
Mailing Address - Fax:954-942-3904
Practice Address - Street 1:2001 N FEDERAL HWY
Practice Address - Street 2:STE.#206
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1030
Practice Address - Country:US
Practice Address - Phone:954-942-3937
Practice Address - Fax:954-942-3904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96010261QM2500X, 261QS0132X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty