Provider Demographics
NPI:1942077045
Name:THEORY EYECARE LLC
Entity Type:Organization
Organization Name:THEORY EYECARE LLC
Other - Org Name:THEORY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:AYEESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:407-923-5191
Mailing Address - Street 1:2680 N ORANGE AVE APT 1338
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4733
Mailing Address - Country:US
Mailing Address - Phone:407-923-5191
Mailing Address - Fax:
Practice Address - Street 1:7091 NARCOOSSEE ROAD
Practice Address - Street 2:102
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-5566
Practice Address - Country:US
Practice Address - Phone:689-228-5102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty