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NPI Code Detail

MEDICARE: L.C. ERBE O.D. P.A.

MEDICARE: L.C. ERBE O.D. 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
1152WP0200XPediatric OptometristOPC 3336FL
2152WS0006XSports Vision OptometristOPC 3336FL
3152WV0400XVision Therapy OptometristOPC 3336FL
4152W00000XOptometristOPC 3336FL

Other Identifiers

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

General Provider Information

NPI Number : 1487024568
Entity Type Code : Organization
Provider Name (Legal Business Name) : L.C. ERBE O.D. P.A.
Provider Business Mailing Address
First Line : 474 SW HOMELAND RD
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34953-6278
Country : US
Telephone Number : 772-873-0037
Fax Number :
Provider Business Practice Location Address
First Line : 1721 SW GATLIN BLVD
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34953-2757
Country : US
Telephone Number : 772-873-0037
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. LYNNE C ERBE
Credential : OD
Telephone Number : 772-873-0037
Provider Enumeration Date : 10/01/2015
Last Update Date : 10/01/2015

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