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General NPI Number Information
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NPI Number | 1215341755
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Entity Type | Organization
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Legal Business Name | QUALITY EYE CARE INC
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 01/07/2016
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Provider Practice Location Address
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Address Line | 13241 BARTRAM PARK BLVD SUITE 1505
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5212
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Country | US
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Telephone | 904-374-6890
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Fax |
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Provider Business Mailing Address
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Address Line | 13241 BARTRAM PARK BLVD SUITE 1505
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5212
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Country | US
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Telephone | 904-374-6890
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HAZEM M SAMY
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Credential | MD
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Telephone | 904-445-9981
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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 | FL
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