1073598751 NPI number — WESTON EYE CENTER, INC.

Table of content: (NPI 1073598751)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073598751 NPI number — WESTON EYE CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTON EYE CENTER, 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:
Provider Other Organization Name Type Code:
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:
1073598751
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4577 WESTON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33331-3141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-217-5070
Provider Business Mailing Address Fax Number:
954-217-5080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4577 WESTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33331-3141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-217-5070
Provider Business Practice Location Address Fax Number:
954-217-5080
Provider Enumeration Date:
12/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DEL TORO
Authorized Official First Name:
LUISA
Authorized Official Middle Name:
INES
Authorized Official Title or Position:
OWNER/OPTOMETRIST
Authorized Official Telephone Number:
954-217-5070

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  3106 , 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)

  • Identifier: WE08428 . This is a "SPECTERA - HEALTH PLAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 06031 . This is a "DAVIS VISION - HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 20037 . This is a "CIGNA OCCUCARE - HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 3106 . This is a "VISION BENEFITS OF AMERIC" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 613027 . This is a "VCI - BROWARD SCHOOLS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: FL3106 . This is a "EYEMED - HEALTH PLAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 206497 . This is a "CLARITYVISION - HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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