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NPI Code Detail

MEDICARE: PREMIER EYE ASSOCIATES, INC.

MEDICARE: PREMIER EYE ASSOCIATES, INC.
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
1152W00000XOptometristOPC3191FL

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 : 1629228424
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER EYE ASSOCIATES, INC.
Provider Business Mailing Address
First Line : 2255 S SEMORAN BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32822-2703
Country : US
Telephone Number : 407-208-1998
Fax Number : 407-208-0430
Provider Business Practice Location Address
First Line : 2255 S SEMORAN BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32822-2703
Country : US
Telephone Number : 407-208-1998
Fax Number : 407-208-0430
Authorized Official
Title or Position : OD / PRESIDENT
Name : DR. DANNY TU
Credential : OD
Telephone Number : 407-208-1998
Provider Enumeration Date : 09/29/2008
Last Update Date : 06/25/2009

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Directions to “PREMIER EYE ASSOCIATES, INC. ” Practice Location

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