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General NPI Number Information
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NPI Number | 1629104674
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Entity Type | Organization
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Legal Business Name | ADVANCED MEDICAL EYE CONSULTANTS LLC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 12/30/2008
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Provider Practice Location Address
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Address Line | 6801 US HIGHWAY 27 N SUITE D-3
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City | SEBRING
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State | FL
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Zip | 33870-7840
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Country | US
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Telephone | 863-382-7300
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Fax | 486-243-0007
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Provider Business Mailing Address
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Address Line | PO BOX 1195
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City | SEBRING
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State | FL
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Zip | 33871-1195
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Country | US
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Telephone | 863-382-7300
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Fax | 786-243-0007
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. L.D. IAN ROE
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Credential | M.D.
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Telephone | 863-382-7300
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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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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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Taxonomy #3
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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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