Healthcare Provider Details

I. General information

NPI: 1306367461
Provider Name (Legal Business Name): IFOCUS OPTOMETRY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2017
Last Update Date: 06/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8177 GLADES RD STE 3
BOCA RATON FL
33434-4063
US

IV. Provider business mailing address

2036 DISCOVERY CIR E
DEERFIELD BEACH FL
33442-1044
US

V. Phone/Fax

Practice location:
  • Phone: 561-479-4765
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number004116
License Number StateFL

VIII. Authorized Official

Name: DR. SCOTT MERVYN BROWN
Title or Position: PRESIDENT/OPTOMETRIST
Credential: OD
Phone: 954-304-7850