Healthcare Provider Details

I. General information

NPI: 1568239325
Provider Name (Legal Business Name): EYEGLASS.COM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14650 MOSSY HAMMOCK LN
MYAKKA CITY FL
34251-2009
US

IV. Provider business mailing address

14650 MOSSY HAMMOCK LN
MYAKKA CITY FL
34251-2009
US

V. Phone/Fax

Practice location:
  • Phone: 941-780-8463
  • Fax:
Mailing address:
  • Phone: 941-780-8463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES MORRISON
Title or Position: PRESIDENT
Credential:
Phone: 941-780-8463