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General NPI Number Information
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NPI Number | 1487024568
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Entity Type | Organization
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Legal Business Name | L.C. ERBE O.D. P.A.
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 10/01/2015
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Provider Practice Location Address
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Address Line | 1721 SW GATLIN BLVD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-2757
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Country | US
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Telephone | 772-873-0037
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Fax |
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Provider Business Mailing Address
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Address Line | 474 SW HOMELAND RD
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-6278
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Country | US
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Telephone | 772-873-0037
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LYNNE C ERBE
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Credential | OD
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Telephone | 772-873-0037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | OPC 3336
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number | OPC 3336
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | OPC 3336
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 3336
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License Number State | FL
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