Healthcare Provider Details

I. General information

NPI: 1013752831
Provider Name (Legal Business Name): HOBE SOUND EYE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11714 SE FEDERAL HWY
HOBE SOUND FL
33455-5303
US

IV. Provider business mailing address

9398 SE SHARON ST
HOBE SOUND FL
33455-6835
US

V. Phone/Fax

Practice location:
  • Phone: 772-546-4116
  • Fax:
Mailing address:
  • Phone: 561-801-6749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. CATHERINE DEREWYANKO
Title or Position: OPTOMETRIST
Credential: OD
Phone: 561-801-6749