Provider Demographics
NPI:1245546605
Name:CHRYCY, MATTHEW (OD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:CHRYCY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:CHRYCY
Other - Middle Name:
Other - Last Name:LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1201 BRICKELL AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3207
Mailing Address - Country:US
Mailing Address - Phone:305-905-6900
Mailing Address - Fax:
Practice Address - Street 1:1201 BRICKELL AVE
Practice Address - Street 2:STE 300
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-3207
Practice Address - Country:US
Practice Address - Phone:305-905-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4514152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist