Provider Demographics
NPI:1629361902
Name:TREASURE COAST OPTICAL, INC.
Entity Type:Organization
Organization Name:TREASURE COAST OPTICAL, INC.
Other - Org Name:DR. TARI SCHMIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TARI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:772-398-4500
Mailing Address - Street 1:1331 SE PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5331
Mailing Address - Country:US
Mailing Address - Phone:772-398-4500
Mailing Address - Fax:772-398-4502
Practice Address - Street 1:1331 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5331
Practice Address - Country:US
Practice Address - Phone:772-398-4500
Practice Address - Fax:772-398-4502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC-3420152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1306046925OtherNPI