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General NPI Number Information
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NPI Number | 1114199205
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Entity Type | Organization
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Legal Business Name | OPHTHALMOLOGY CONSULTANTS PA
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 01/29/2010
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Provider Practice Location Address
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Address Line | 5800 COLONIAL DRIVE SUITE #100
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City | MARGATE
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State | FL
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Zip | 33063-5682
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Country | US
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Telephone | 954-977-8770
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Fax | 954-977-8774
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Provider Business Mailing Address
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Address Line | 5800 COLONIAL DRIVE SUITE 100
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City | MARGATE
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State | FL
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Zip | 33063-5682
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Country | US
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Telephone | 954-977-8770
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Fax | 954-977-8774
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Authorized Official
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Title or Position | PHYSICIAN
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Name | WILLIAM R BURKS
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Credential | MD
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Telephone | 954-977-8770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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