Provider Demographics
NPI:1184393720
Name:TRUE EYE EXPERTS WEST PALM LLC
Entity type:Organization
Organization Name:TRUE EYE EXPERTS WEST PALM LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:BASHLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-642-9100
Mailing Address - Street 1:19070 BRUCE B DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2477
Mailing Address - Country:US
Mailing Address - Phone:813-632-2020
Mailing Address - Fax:813-631-9802
Practice Address - Street 1:634 21ST ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-0933
Practice Address - Country:US
Practice Address - Phone:772-567-6513
Practice Address - Fax:813-631-9802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty