MEDICARE: YARABU EYE CARE, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154892990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YARABU EYE CARE, P.A.

Provider Business Mailing Address
First Line	:	11523 PALMBRUSH TRL # 124
Second Line	:
City	:	LAKEWOOD RANCH
State	:	FL
Zip	:	34202-2917
Country	:	US
Telephone Number	:	941-567-4675
Fax Number	:

Provider Business Practice Location Address
First Line	:	1141 53RD AVE W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-2858
Country	:	US
Telephone Number	:	941-567-4675
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALBERT ALEXANDER LASCAIBAR
Credential	:	OD
Telephone Number	:	941-567-4675

Provider Enumeration Date	:	12/05/2018
Last Update Date	:	12/05/2018

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