Provider Demographics
NPI:1598945438
Name:DAPORE VISION CARE LLC
Entity Type:Organization
Organization Name:DAPORE VISION CARE LLC
Other - Org Name:FRANK P. DAPORE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAPORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-878-8800
Mailing Address - Street 1:1877 S MAPLE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-3460
Mailing Address - Country:US
Mailing Address - Phone:937-878-8800
Mailing Address - Fax:937-878-8802
Practice Address - Street 1:1877 S MAPLE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-3460
Practice Address - Country:US
Practice Address - Phone:937-878-8800
Practice Address - Fax:937-878-8802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3017152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHT46693Medicare UPIN
OH0803400001Medicare NSC