Provider Demographics
NPI:1831436146
Name:PREMIER EYE CENTER INC
Entity type:Organization
Organization Name:PREMIER EYE CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEHOE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-964-1359
Mailing Address - Street 1:3650 FOREST HILL BLVD STE 2
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5662
Mailing Address - Country:US
Mailing Address - Phone:561-964-1359
Mailing Address - Fax:561-964-8771
Practice Address - Street 1:3650 FOREST HILL BLVD STE 2
Practice Address - Street 2:SUITE 2
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5662
Practice Address - Country:US
Practice Address - Phone:561-964-1359
Practice Address - Fax:561-964-8771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4614152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty