Provider Demographics
NPI:1558783407
Name:ICU EYE ASSOCIATES
Entity Type:Organization
Organization Name:ICU EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:MOLINA
Authorized Official - Last Name:DAMBROSIO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-604-9738
Mailing Address - Street 1:966 NAUTILUS ISLE
Mailing Address - Street 2:
Mailing Address - City:DANIA
Mailing Address - State:FL
Mailing Address - Zip Code:33004
Mailing Address - Country:US
Mailing Address - Phone:954-604-9738
Mailing Address - Fax:
Practice Address - Street 1:966 NAUTILUS ISLE
Practice Address - Street 2:
Practice Address - City:DANIA
Practice Address - State:FL
Practice Address - Zip Code:33004-2356
Practice Address - Country:US
Practice Address - Phone:954-604-9738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC#3578152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty