Provider Demographics
NPI:1598191181
Name:ICONIC EYE CARE INC
Entity Type:Organization
Organization Name:ICONIC EYE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-336-0733
Mailing Address - Street 1:1183 OLD DIXIE HWY STE A
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-2343
Mailing Address - Country:US
Mailing Address - Phone:954-224-1486
Mailing Address - Fax:561-863-9010
Practice Address - Street 1:1183 OLD DIXIE HWY STE A
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-2343
Practice Address - Country:US
Practice Address - Phone:954-224-1486
Practice Address - Fax:561-863-9010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4711282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital