MEDICARE: FRIENDLY EYES OPTOMETRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1811708977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDLY EYES OPTOMETRY LLC

Provider Business Mailing Address
First Line	:	8990 N DAVIS HWY APT 6
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32514-5304
Country	:	US
Telephone Number	:	513-222-8136
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 N FEDERAL HWY UNIT 120
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-1018
Country	:	US
Telephone Number	:	513-222-8136
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	BARRY CONCOOL
Credential	:	MD
Telephone Number	:	513-222-8136

Provider Enumeration Date	:	01/17/2025
Last Update Date	:	01/17/2025

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