Provider Demographics
NPI:1801196597
Name:EYE CARE OF FLORIDA LLC
Entity Type:Organization
Organization Name:EYE CARE OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:217-816-4441
Mailing Address - Street 1:7833 N SOUTHWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3833
Mailing Address - Country:US
Mailing Address - Phone:217-816-4441
Mailing Address - Fax:
Practice Address - Street 1:430 S DIXIE HWY
Practice Address - Street 2:#5
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2273
Practice Address - Country:US
Practice Address - Phone:305-669-3890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4532152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty