Provider Demographics
NPI:1528375649
Name:EYE OPENERZ P A
Entity Type:Organization
Organization Name:EYE OPENERZ P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHUTA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-868-6219
Mailing Address - Street 1:5005 MAXWELL CIR
Mailing Address - Street 2:UNIT 201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-4530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9885 COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-2638
Practice Address - Country:US
Practice Address - Phone:239-775-5791
Practice Address - Fax:239-455-4877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3641152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U0379AMedicare UPIN
94500Medicare PIN