Provider Demographics
NPI:1013445956
Name:EYE CARE VISION GROUP P.A.
Entity Type:Organization
Organization Name:EYE CARE VISION GROUP P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARLINGTON
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:772-286-1090
Mailing Address - Street 1:3382 NW FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-4404
Mailing Address - Country:US
Mailing Address - Phone:772-286-1090
Mailing Address - Fax:772-286-1214
Practice Address - Street 1:3382 NW FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-4404
Practice Address - Country:US
Practice Address - Phone:772-286-1090
Practice Address - Fax:772-286-1214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-23
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2430152W00000X
261QM1300X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty