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General NPI Number Information
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NPI Number | 1932363934
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Entity Type | Organization
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Legal Business Name | PREMIER EYE CARE OF FLORIDA LLC
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Dates
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Enumeration Date | 07/18/2008
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 4565 PONCE DE LEON BLVD STE 200
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City | CORAL GABLES
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State | FL
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Zip | 33146-1855
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Country | US
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Telephone | 561-455-9002
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 980216
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City | WEST SACRAMENTO
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State | CA
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Zip | 95798-0216
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Country | US
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Telephone | 561-455-9002
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Fax | 800-523-3788
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Authorized Official
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Title or Position | COO
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Name | JASON PANOS
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Credential |
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Telephone | 561-455-9002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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