Provider Demographics
NPI:1538459532
Name:SERENITY EYE CARE PC
Entity Type:Organization
Organization Name:SERENITY EYE CARE PC
Other - Org Name:JUSTIN-VENI AND TERRI-ANN ECHAGUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRI-ANN
Authorized Official - Middle Name:BAILEY
Authorized Official - Last Name:ECHAGUE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-593-0902
Mailing Address - Street 1:8853 WOODGROVE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-4872
Mailing Address - Country:US
Mailing Address - Phone:964-593-0902
Mailing Address - Fax:
Practice Address - Street 1:8853 WOODGROVE RIDGE CT
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33473-4872
Practice Address - Country:US
Practice Address - Phone:964-593-0902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002027152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty