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General NPI Number Information
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NPI Number | 1427384239
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Entity Type | Organization
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Legal Business Name | ADVANCED VISION CARE OF JUPITER INC
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Dates
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Enumeration Date | 10/29/2009
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Last Update Date | 07/24/2019
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Provider Practice Location Address
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Address Line | 3893 MILITARY TRL STE 4
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City | JUPITER
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State | FL
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Zip | 33458-2936
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Country | US
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Telephone | 561-429-8753
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Fax | 561-630-7066
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Provider Business Mailing Address
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Address Line | 1200 TOWN CENTER DR
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City | JUPITER
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State | FL
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Zip | 33458-5256
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Country | US
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Telephone | 561-429-8753
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Fax | 561-630-7066
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Authorized Official
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Title or Position | P
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Name | DR. AMIR CUKIERMAN
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Credential | OD
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Telephone | 954-850-1454
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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 | FL2861
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License Number State | ZZ
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