Provider Demographics
NPI:1891985404
Name:I CARE OPTICAL PA
Entity Type:Organization
Organization Name:I CARE OPTICAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:EFRE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:813-806-0812
Mailing Address - Street 1:5537 SHELDON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3153
Mailing Address - Country:US
Mailing Address - Phone:813-806-0812
Mailing Address - Fax:813-249-2049
Practice Address - Street 1:5537 SHELDON RD
Practice Address - Street 2:SUITE A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3153
Practice Address - Country:US
Practice Address - Phone:813-806-0812
Practice Address - Fax:813-249-2049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFP907AMedicare PIN