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General NPI Number Information
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NPI Number | 1376900720
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Entity Type | Organization
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Legal Business Name | CEC, LLC
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 01/18/2016
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Provider Practice Location Address
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Address Line | 128 BUCKSPORT RD SUITE B
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City | ELLSWORTH
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State | ME
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Zip | 04605-2239
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Country | US
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Telephone | 207-667-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 401 COMMERCE ST SUITE A
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City | NASHVILLE
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State | TN
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Zip | 37219-2446
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Country | US
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Telephone | 615-843-4109
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | LAWRENCE PIAZZA
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Credential |
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Telephone | 615-843-4109
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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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