Healthcare Provider Details

I. General information

NPI: 1386658110
Provider Name (Legal Business Name): PROFESSIONAL EYE CARE CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 W 74TH PL
HIALEAH FL
33014-5058
US

IV. Provider business mailing address

285 W 74TH PL
HIALEAH FL
33014-5058
US

V. Phone/Fax

Practice location:
  • Phone: 305-557-9004
  • Fax: 305-362-2885
Mailing address:
  • Phone: 305-557-9004
  • Fax: 305-362-2885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC1156
License Number StateFL

VIII. Authorized Official

Name: DR. STEPHEN HOUGHTON
Title or Position: PRESIDENT
Credential: O.D.
Phone: 305-557-9004