Provider Demographics
NPI:1255953865
Name:FLORIDA SHORES VISION, INC
Entity type:Organization
Organization Name:FLORIDA SHORES VISION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SLUSKY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-477-5612
Mailing Address - Street 1:301 174TH ST APT 2001
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3238
Mailing Address - Country:US
Mailing Address - Phone:847-477-5612
Mailing Address - Fax:
Practice Address - Street 1:2551 E HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4818
Practice Address - Country:US
Practice Address - Phone:954-455-1205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-18
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty