Provider Demographics
NPI:1801059704
Name:EYECARE AND EYEWEAR INC
Entity type:Organization
Organization Name:EYECARE AND EYEWEAR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:SV
Authorized Official - Last Name:BISSESSAR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:407-497-6203
Mailing Address - Street 1:2679 METROSEVILLA DR
Mailing Address - Street 2:UNIT 110
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-9030
Mailing Address - Country:US
Mailing Address - Phone:407-497-6203
Mailing Address - Fax:
Practice Address - Street 1:3402 TECHNOLOGICAL AVE
Practice Address - Street 2:SUITE 124
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1402
Practice Address - Country:US
Practice Address - Phone:407-208-1890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3871152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty