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General NPI Number Information
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NPI Number | 1174265995
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Entity Type | Organization
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Legal Business Name | W&E EYECARE LLC
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 2001 N FEDERAL HWY UNIT 120
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City | POMPANO BEACH
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State | FL
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Zip | 33062-1018
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Country | US
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Telephone | 954-785-2655
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Fax |
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Provider Business Mailing Address
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Address Line | 361 N UNIVERSITY DR APT 414
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City | PLANTATION
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State | FL
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Zip | 33324-2055
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Country | US
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Telephone | 314-602-0087
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. CANDACE ELLIS
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Credential | OD
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Telephone | 314-602-0087
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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 |
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License Number State |
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