Provider Demographics
NPI:1750579850
Name:ANTHONY SCHAFFER OD MBA PL
Entity type:Organization
Organization Name:ANTHONY SCHAFFER OD MBA PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT REPRESENTATIVE
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MEILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-471-1413
Mailing Address - Street 1:3810 DIVOT RD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-1276
Mailing Address - Country:US
Mailing Address - Phone:863-471-1413
Mailing Address - Fax:863-471-1416
Practice Address - Street 1:3525 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1640
Practice Address - Country:US
Practice Address - Phone:863-471-1413
Practice Address - Fax:863-471-1416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3395152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620922000Medicaid
FL68093ZOtherBCBS
FL366062820OtherCHAMPUS
FLOPC3395OtherSTATE LICENSE
FL68093ZMedicare PIN