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General NPI Number Information
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NPI Number | 1124198668
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Entity Type | Organization
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Legal Business Name | BELFAIR EYE CARE CENTER
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18 OAK FOREST RD STE A
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City | BLUFFTON
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State | SC
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Zip | 29910-4990
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Country | US
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Telephone | 843-815-3415
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Fax | 843-815-3417
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Provider Business Mailing Address
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Address Line | 18 OAK FOREST RD STE A
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City | BLUFFTON
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State | SC
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Zip | 29910-4990
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Country | US
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Telephone | 843-815-3415
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Fax | 843-815-3417
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. DEBORAH MARIE AMOROSO
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Credential | O.D.
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Telephone | 843-815-3415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1332
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License Number State | SC
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