MEDICARE: LAKE HAVASU FAMILY EYECARE, LLC

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	1311	AZ

General Provider Information

NPI Number	:	1457569121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKE HAVASU FAMILY EYECARE, LLC

Provider Business Mailing Address
First Line	:	2277 SWANSON AVE STE 100
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5991
Country	:	US
Telephone Number	:	928-855-5026
Fax Number	:	928-854-4512

Provider Business Practice Location Address
First Line	:	2277 SWANSON AVE STE 100
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5991
Country	:	US
Telephone Number	:	928-855-5026
Fax Number	:	928-854-4512

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TANIA NICOLE SOBCHUK
Credential	:	O.D.
Telephone Number	:	928-855-5026

Provider Enumeration Date	:	05/18/2007
Last Update Date	:	01/09/2019

Similar Medicare Providers

1114366358 — REBECCA A BASSHAM BS, RT
Practice Location Address:

2277 SWANSON AVE , SUITE B
LAKE HAVASU CITY, AZ
86403-5991

Practice Phone: 928-486-5414
Practice Fax: 928-854-0112

1548817786 — CHRISTINA ANN MARTINEZ OD
Practice Location Address:

2277 SWANSON AVE STE 100
LAKE HAVASU CITY, AZ
86403-5991

Practice Phone: 928-855-5026
Practice Fax:

1912643578 — KKTZ DENTAL PLLC
Practice Location Address:

2277 SWANSON AVE STE E
LAKE HAVASU CITY, AZ
86403-5991

Practice Phone: 928-680-6222
Practice Fax:

1356892483 — DALTON BARRIER
Practice Location Address:

350 LAKE FORREST RD
LYNCHBURG, TN
37352-5991

Practice Phone: 931-307-4590
Practice Fax:

1619411584 — SONIA GIANNATTASIO
Practice Location Address:

150 51ST AVE
LONG ISLAND CITY, NY
11101-5991

Practice Phone: 718-609-3320
Practice Fax:

1023552783 — DANIELA GRECI
Practice Location Address:

150 51ST AVE
LONG ISLAND CITY, NY
11101-5991

Practice Phone: 718-609-3320
Practice Fax:

Directions to “LAKE HAVASU FAMILY EYECARE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.