Provider Demographics
NPI:1821278987
Name:MCMURDO FAMILY VISION CARE, P.A.
Entity Type:Organization
Organization Name:MCMURDO FAMILY VISION CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:MCMURDO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:351-597-3935
Mailing Address - Street 1:13300 CORTEZ BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-4887
Mailing Address - Country:US
Mailing Address - Phone:352-597-3935
Mailing Address - Fax:352-596-2668
Practice Address - Street 1:13300 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-4887
Practice Address - Country:US
Practice Address - Phone:352-597-3935
Practice Address - Fax:352-596-2668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3711152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5935Medicare PIN
FLU93048Medicare UPIN