1508818584 NPI number — SUZANNE M. DAY, O.D. INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508818584 NPI number — SUZANNE M. DAY, O.D. INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUZANNE M. DAY, O.D. INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
GULF BREEZE EYE CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508818584
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/05/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
97 BAY BRIDGE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GULF BREEZE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32561-4468
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-932-4184
Provider Business Mailing Address Fax Number:
850-932-9353

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
97 BAY BRIDGE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GULF BREEZE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32561-4468
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-932-4184
Provider Business Practice Location Address Fax Number:
850-932-9353
Provider Enumeration Date:
05/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DAY
Authorized Official First Name:
SUZANNE
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
850-932-4184

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OPC 4091 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)