MEDICARE: PRECISION EYE CARE LTD

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	152WC0802X	Corneal and Contact Management Optometrist	OPC 3910	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1932201878	OTHER		PERSONAL NPI

General Provider Information

NPI Number	:	1639393150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION EYE CARE LTD

Provider Business Mailing Address
First Line	:	194 CARSON OAKS LN
Second Line	:
City	:	SANTA ROSA BEACH
State	:	FL
Zip	:	32459-7158
Country	:	US
Telephone Number	:	850-502-9575
Fax Number	:

Provider Business Practice Location Address
First Line	:	1621 MAIN ST
Second Line	:	WALMART VISION CENTER
City	:	CHIPLEY
State	:	FL
Zip	:	32428-5992
Country	:	US
Telephone Number	:	850-638-3214
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KORRIE LYNN LALIM
Credential	:	O.D.
Telephone Number	:	850-502-9575

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	08/22/2020

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