Provider Demographics
NPI:1629231394
Name:APPLE EYES VISION CENTER
Entity Type:Organization
Organization Name:APPLE EYES VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DR
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:APPELQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:352-854-3088
Mailing Address - Street 1:3101 SW 34TH AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-4431
Mailing Address - Country:US
Mailing Address - Phone:352-854-3088
Mailing Address - Fax:352-854-9501
Practice Address - Street 1:3101 SW 34TH AVE
Practice Address - Street 2:STE 201
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4431
Practice Address - Country:US
Practice Address - Phone:352-854-3088
Practice Address - Fax:352-854-9501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0919020001OtherPALMETTO GBA-A
FL225225OtherAVMED
FL28769OtherSPECTERA
FL112668OtherEYEMED
FL180005596OtherRAILROAD MEDICARE
FL225225OtherAVMED
FL28769OtherSPECTERA