Healthcare Provider Details

I. General information

NPI: 1710891700
Provider Name (Legal Business Name): PARK AVENUE OPHTHALMICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 VISTA PKWY STE 100A
WEST PALM BEACH FL
33411-6700
US

IV. Provider business mailing address

2005 VISTA PKWY STE 100A
WEST PALM BEACH FL
33411-6700
US

V. Phone/Fax

Practice location:
  • Phone: 561-747-3937
  • Fax: 561-747-8822
Mailing address:
  • Phone: 561-747-3937
  • Fax: 561-747-8822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHN T LEHR
Title or Position: MD
Credential:
Phone: 407-893-8200