Provider Demographics
NPI:1477397321
Name:FLORIDA EYE WELLNESS LLC
Entity type:Organization
Organization Name:FLORIDA EYE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:727-967-7288
Mailing Address - Street 1:9537 RIVERCHASE DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5732
Mailing Address - Country:US
Mailing Address - Phone:727-967-7288
Mailing Address - Fax:
Practice Address - Street 1:8701 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-5349
Practice Address - Country:US
Practice Address - Phone:727-848-9571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty