Provider Demographics
NPI:1629795893
Name:ECB EYE FLORIDA CORP
Entity Type:Organization
Organization Name:ECB EYE FLORIDA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:NEVARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-644-1781
Mailing Address - Street 1:8001 S ORANGE BLOSSOM TRL STE 1560
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-7654
Mailing Address - Country:US
Mailing Address - Phone:939-644-1781
Mailing Address - Fax:
Practice Address - Street 1:8001 S ORANGE BLOSSOM TRL STE 1560
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7654
Practice Address - Country:US
Practice Address - Phone:939-644-1781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty