Healthcare Provider Details

I. General information

NPI: 1538309851
Provider Name (Legal Business Name): BELVEDERE EYE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2009
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2891 N DECATUR RD STE F
DECATUR GA
30033-7426
US

IV. Provider business mailing address

2891 N DECATUR RD STE F
DECATUR GA
30033-7426
US

V. Phone/Fax

Practice location:
  • Phone: 770-380-0346
  • Fax: 404-534-1242
Mailing address:
  • Phone: 770-380-0346
  • Fax: 404-534-1242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number1143T
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1143T
License Number StateGA

VIII. Authorized Official

Name: HOWARD I GINSBURG
Title or Position: TREASURER
Credential: CPA
Phone: 770-380-0346