Provider Demographics
NPI:1508044819
Name:UONG EYE CARE PA
Entity Type:Organization
Organization Name:UONG EYE CARE PA
Other - Org Name:UONG EYE CARE PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SOKONVISET
Authorized Official - Middle Name:
Authorized Official - Last Name:UONG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:407-656-6870
Mailing Address - Street 1:3708 WINTER GARDEN VINELAND RD
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5483
Mailing Address - Country:US
Mailing Address - Phone:407-656-6870
Mailing Address - Fax:407-656-7540
Practice Address - Street 1:3708 WINTER GARDEN VINELAND RD
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5483
Practice Address - Country:US
Practice Address - Phone:407-656-6870
Practice Address - Fax:407-656-7540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3669152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH279AMedicare UPIN