Provider Demographics
NPI:1578618799
Name:EAST COAST OPTICS, INC.
Entity Type:Organization
Organization Name:EAST COAST OPTICS, INC.
Other - Org Name:PEARLE VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSWALD
Authorized Official - Middle Name:NEELY
Authorized Official - Last Name:CARNATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:321-452-2540
Mailing Address - Street 1:777 E MERRITT ISLAND CSWY
Mailing Address - Street 2:#200 A
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-3576
Mailing Address - Country:US
Mailing Address - Phone:321-452-2540
Mailing Address - Fax:321-452-7345
Practice Address - Street 1:777 E MERRITT ISLAND CSWY
Practice Address - Street 2:#200 A
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-3576
Practice Address - Country:US
Practice Address - Phone:321-452-2540
Practice Address - Fax:321-452-7345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0000844156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty