Provider Demographics
NPI:1649640905
Name:DR. BARRY CASE LLC
Entity type:Organization
Organization Name:DR. BARRY CASE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:AVI
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:941-421-2684
Mailing Address - Street 1:11212 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-4752
Mailing Address - Country:US
Mailing Address - Phone:727-393-1501
Mailing Address - Fax:727-393-2882
Practice Address - Street 1:11212 PARK BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-4752
Practice Address - Country:US
Practice Address - Phone:727-393-1501
Practice Address - Fax:727-393-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4974152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty