Provider Demographics
NPI:1932484276
Name:FLORIDA FAMILY EYE CARE, P.A.
Entity Type:Organization
Organization Name:FLORIDA FAMILY EYE CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:CONSIGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:941-748-3611
Mailing Address - Street 1:6225 E STATE ROAD 64
Mailing Address - Street 2:ATTN: VISION CENTER
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-6244
Mailing Address - Country:US
Mailing Address - Phone:941-748-3611
Mailing Address - Fax:
Practice Address - Street 1:6225 E STATE ROAD 64
Practice Address - Street 2:ATTN: VISION CENTER
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-6244
Practice Address - Country:US
Practice Address - Phone:941-748-3611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2798152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty