Healthcare Provider Details

I. General information

NPI: 1306260112
Provider Name (Legal Business Name): HOME EYE CARE SOLUTIONS, PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2014
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12587 NW 83RD CT
PARKLAND FL
33076-4934
US

IV. Provider business mailing address

12587 NW 83RD CT
PARKLAND FL
33076-4934
US

V. Phone/Fax

Practice location:
  • Phone: 305-615-1177
  • Fax: 305-615-1664
Mailing address:
  • Phone: 305-615-1177
  • Fax: 305-615-1664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: MIGUEL A DE FALCO
Title or Position: MANAGER
Credential: OD
Phone: 305-615-1177