Provider Demographics
NPI:1750642278
Name:E&C HEALTH SERVICES PA
Entity Type:Organization
Organization Name:E&C HEALTH SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:727-641-7485
Mailing Address - Street 1:3451 E LOUISE LN
Mailing Address - Street 2:SUITE 124
Mailing Address - City:HERNANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34442-4396
Mailing Address - Country:US
Mailing Address - Phone:727-641-7485
Mailing Address - Fax:
Practice Address - Street 1:3451 E LOUISE LN
Practice Address - Street 2:SUITE 124
Practice Address - City:HERNANDO
Practice Address - State:FL
Practice Address - Zip Code:34442-4396
Practice Address - Country:US
Practice Address - Phone:727-641-7485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620979300Medicaid
FL620979300Medicaid