Provider Demographics
NPI:1558536466
Name:ARCADIA EYEWEAR INC.
Entity Type:Organization
Organization Name:ARCADIA EYEWEAR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OPTICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:FANTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:863-993-9911
Mailing Address - Street 1:14 S POLK AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266-3950
Mailing Address - Country:US
Mailing Address - Phone:863-993-9911
Mailing Address - Fax:863-993-1022
Practice Address - Street 1:14 S POLK AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-3950
Practice Address - Country:US
Practice Address - Phone:863-993-9911
Practice Address - Fax:863-993-1022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO 4027332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1296310001Medicare NSC