Provider Demographics
NPI:1770627820
Name:DASSLER EYE CONSULTANTS INC
Entity Type:Organization
Organization Name:DASSLER EYE CONSULTANTS INC
Other - Org Name:PURCELL EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:DASSLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-866-7247
Mailing Address - Street 1:9543 HARDING AVE
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2501
Mailing Address - Country:US
Mailing Address - Phone:305-866-7247
Mailing Address - Fax:305-866-4005
Practice Address - Street 1:9543 HARDING AVE
Practice Address - Street 2:
Practice Address - City:SURFSIDE
Practice Address - State:FL
Practice Address - Zip Code:33154-2501
Practice Address - Country:US
Practice Address - Phone:305-866-7247
Practice Address - Fax:305-866-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC0003322152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5870360001OtherDMERC