Provider Demographics
NPI:1558624916
Name:I SEE CLEARLY EYEWEAR
Entity Type:Organization
Organization Name:I SEE CLEARLY EYEWEAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMITRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CIANACK
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAVAMI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:754-222-6046
Mailing Address - Street 1:2755 W ATLANTIC BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-2625
Mailing Address - Country:US
Mailing Address - Phone:754-222-6046
Mailing Address - Fax:754-222-6046
Practice Address - Street 1:2755 W ATLANTIC BLVD STE 105
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-2625
Practice Address - Country:US
Practice Address - Phone:754-222-6046
Practice Address - Fax:754-222-6046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty