Provider Demographics
NPI:1487824306
Name:EYE CARE PROFESSIONALS, P.A.
Entity Type:Organization
Organization Name:EYE CARE PROFESSIONALS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-681-7801
Mailing Address - Street 1:3674 HAMILTON KY
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-6466
Mailing Address - Country:US
Mailing Address - Phone:561-681-7801
Mailing Address - Fax:561-478-2609
Practice Address - Street 1:3200 OLD BOYNTON RD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-6506
Practice Address - Country:US
Practice Address - Phone:561-737-0510
Practice Address - Fax:561-478-2609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3583152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU93226Medicare UPIN
FLU93225Medicare UPIN