Provider Demographics
NPI:1760904312
Name:MARGATE EYECARE
Entity Type:Organization
Organization Name:MARGATE EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:NOELLE
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-973-2150
Mailing Address - Street 1:258 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-4557
Mailing Address - Country:US
Mailing Address - Phone:954-895-2484
Mailing Address - Fax:
Practice Address - Street 1:258 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33067-3306
Practice Address - Country:US
Practice Address - Phone:954-973-2150
Practice Address - Fax:954-973-1668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO6413332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier