Provider Demographics
NPI:1801217971
Name:EVA KAREN BOSWELL O.D.P.A
Entity Type:Organization
Organization Name:EVA KAREN BOSWELL O.D.P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EVA
Authorized Official - Middle Name:KAREN
Authorized Official - Last Name:BOSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:863-318-9966
Mailing Address - Street 1:7450 CYPRESS GARDENS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-6200
Mailing Address - Country:US
Mailing Address - Phone:863-318-9966
Mailing Address - Fax:
Practice Address - Street 1:7450 CYPRESS GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-6200
Practice Address - Country:US
Practice Address - Phone:863-318-9966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLOPC1799152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty