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General NPI Number Information
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NPI Number | 1447996657
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Entity Type | Organization
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Legal Business Name | EYE C OPTOMETRY, INC.
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 157 NW 136TH AVE
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City | PLANTATION
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State | FL
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Zip | 33325-2624
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Country | US
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Telephone | 954-851-9944
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Fax |
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Provider Business Mailing Address
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Address Line | 643 HIBISCUS DR
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-6511
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Country | US
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Telephone | 954-696-1902
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIC PHYSICIAN
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Name | DR. CORAL COHEN
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Credential | OD
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Telephone | 954-696-1902
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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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