Healthcare Provider Details

I. General information

NPI: 1629065966
Provider Name (Legal Business Name): DRESNER EYE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8045 SPYGLASS HILL ROAD SUITE 105
VIERA FL
32940-7984
US

IV. Provider business mailing address

8045 SPYGLASS HILL ROAD SUITE 105
VIERA FL
32940-7984
US

V. Phone/Fax

Practice location:
  • Phone: 321-253-1919
  • Fax:
Mailing address:
  • Phone: 321-253-1919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME0055925
License Number StateFL

VIII. Authorized Official

Name: DR. MARK DRESNER
Title or Position: OWNER
Credential: M.D.
Phone: 321-253-1919