Healthcare Provider Details

I. General information

NPI: 1215272653
Provider Name (Legal Business Name): FAMILY EYE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2012
Last Update Date: 07/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12220 W SUNRISE BLVD
PLANTATION FL
33323-2233
US

IV. Provider business mailing address

12220 W SUNRISE BLVD
PLANTATION FL
33323-2233
US

V. Phone/Fax

Practice location:
  • Phone: 954-423-8444
  • Fax:
Mailing address:
  • Phone: 954-423-8444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. MASSIMO R GRAMANZINI
Title or Position: PRESIDENT
Credential: OD
Phone: 954-423-8444