Healthcare Provider Details

I. General information

NPI: 1073598751
Provider Name (Legal Business Name): WESTON EYE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4577 WESTON RD
WESTON FL
33331-3141
US

IV. Provider business mailing address

4577 WESTON RD
WESTON FL
33331-3141
US

V. Phone/Fax

Practice location:
  • Phone: 954-217-5070
  • Fax: 954-217-5080
Mailing address:
  • Phone: 954-217-5070
  • Fax: 954-217-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3106
License Number StateFL

VIII. Authorized Official

Name: DR. LUISA INES DEL TORO
Title or Position: OWNER/OPTOMETRIST
Credential: O.D.
Phone: 954-217-5070