Healthcare Provider Details

I. General information

NPI: 1861396210
Provider Name (Legal Business Name): PANACHE EYE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 PLESSEN
FREDERIKSTED VI
00840-4621
US

IV. Provider business mailing address

4168 JUDITHS FANCY
CHRISTIANSTED VI
00820
US

V. Phone/Fax

Practice location:
  • Phone: 407-361-6688
  • Fax:
Mailing address:
  • Phone: 407-361-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: YOLANDA JARVIS
Title or Position: CO-OWNER
Credential:
Phone: 407-361-6688