Provider Demographics
NPI:1689708802
Name:EYE OPTICS OF BOCA, INC
Entity Type:Organization
Organization Name:EYE OPTICS OF BOCA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-488-6200
Mailing Address - Street 1:9080 KIMBERLY BLVD STE 11
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-2862
Mailing Address - Country:US
Mailing Address - Phone:561-488-6200
Mailing Address - Fax:561-883-0714
Practice Address - Street 1:9080 KIMBERLY BLVD STE 11
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-2862
Practice Address - Country:US
Practice Address - Phone:561-488-6200
Practice Address - Fax:561-883-0714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT84233Medicare UPIN
FL0506110001Medicare NSC
FL0506110001Medicare PIN