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General NPI Number Information
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NPI Number | 1821814294
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Entity Type | Organization
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Legal Business Name | ACCESSIBLE EYE CARE LLC
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 880 N HIGHWAY A1A
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City | INDIALANTIC
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State | FL
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Zip | 32903-3054
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Country | US
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Telephone | 321-729-4340
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Fax | 407-650-2595
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Provider Business Mailing Address
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Address Line | 4045 FENNEC LN
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City | COCOA
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State | FL
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Zip | 32927-2934
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Country | US
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Telephone | 407-346-0091
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Fax | 407-650-2595
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOANNETTE SALAS HERNANDEZ
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Credential | OD
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Telephone | 407-346-0091
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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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