Provider Demographics
NPI:1558878140
Name:EYE TO EYE VISION PLLC
Entity Type:Organization
Organization Name:EYE TO EYE VISION PLLC
Other - Org Name:EYE TO EYE VISION LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNHI
Authorized Official - Middle Name:V
Authorized Official - Last Name:CROMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:951-345-2196
Mailing Address - Street 1:2944 CASTERTON DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7608
Mailing Address - Country:US
Mailing Address - Phone:951-345-2196
Mailing Address - Fax:
Practice Address - Street 1:4305 PINEDA CSWY
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-2316
Practice Address - Country:US
Practice Address - Phone:321-428-2925
Practice Address - Fax:321-428-2926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-04
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4799152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14976500Medicaid