Healthcare Provider Details

I. General information

NPI: 1164954236
Provider Name (Legal Business Name): ESPERANZA EYE CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E OAK ST STE A
KISSIMMEE FL
34744-4574
US

IV. Provider business mailing address

1480 CANOPY PASTURE DR
SAINT CLOUD FL
34771-8886
US

V. Phone/Fax

Practice location:
  • Phone: 407-799-7281
  • Fax:
Mailing address:
  • Phone: 407-319-2702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE ESPERANZA
Title or Position: PRESIDENT
Credential: OD
Phone: 407-799-7281