Provider Demographics
NPI:1023424215
Name:ON SIGHT EYECARE, INC
Entity type:Organization
Organization Name:ON SIGHT EYECARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORA
Authorized Official - Suffix:III
Authorized Official - Credentials:OD
Authorized Official - Phone:813-760-6909
Mailing Address - Street 1:19217 GULF BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIAN SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33785-2111
Mailing Address - Country:US
Mailing Address - Phone:813-760-6909
Mailing Address - Fax:888-505-6009
Practice Address - Street 1:19217 GULF BLVD
Practice Address - Street 2:
Practice Address - City:INDIAN SHORES
Practice Address - State:FL
Practice Address - Zip Code:33785-2111
Practice Address - Country:US
Practice Address - Phone:813-760-6909
Practice Address - Fax:888-505-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHV953AMedicare UPIN