Healthcare Provider Details

I. General information

NPI: 1922435809
Provider Name (Legal Business Name): SEMINOLE EYE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2013
Last Update Date: 10/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3661 S ORLANDO DR
SANFORD FL
32773-5611
US

IV. Provider business mailing address

3661 S ORLANDO DR
SANFORD FL
32773-5611
US

V. Phone/Fax

Practice location:
  • Phone: 407-323-5000
  • Fax: 407-323-7645
Mailing address:
  • Phone: 407-323-5000
  • Fax: 407-323-7645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOBS 4420
License Number StateFL

VIII. Authorized Official

Name: DR. CHRISTOPHER W REED
Title or Position: MANAGER/OWNER
Credential: OD
Phone: 407-323-5000