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NPI Code Detail

MEDICARE: EYEBIS

MEDICARE: EYEBIS
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
1152W00000XOptometrist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649866815
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYEBIS
Provider Business Mailing Address
First Line : 2161 E COUNTY ROAD 540A # 254
Second Line :
City : LAKELAND
State : FL
Zip : 33813-3794
Country : US
Telephone Number : 484-477-2579
Fax Number :
Provider Business Practice Location Address
First Line : 7450 CYPRESS GARDENS BLVD
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-6200
Country : US
Telephone Number : 863-310-0329
Fax Number : 813-318-0348
Authorized Official
Title or Position : MANAGING PROVIDER
Name : KEION MARK
Credential : OD
Telephone Number : 484-477-2579
Provider Enumeration Date : 12/11/2020
Last Update Date : 05/28/2024

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Directions to “EYEBIS ” Practice Location

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