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1162 MILITARY TRAIL LLC NPI 1538417720


NPI Information

NPI: 1538417720
Provider Name: 1162 MILITARY TRAIL LLC

Doing Business As: OPTOMETRIC EYECARE CENTER

Classification: Optometrist - 152WC0802X
Entity Type: Organization

Specialization: Corneal and Contact Management

Address:
1616 S MILITARY TRL
WEST PALM BEACH, FL
ZIP 33415
Phone: (561) 968-1234
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1162 MILITARY TRAIL LLC is a corneal and contact management optometrist in West Palm Beach, FL. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. 1162 MILITARY TRAIL LLC NPI is 1538417720. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Optometric Eyecare Center.

The provider's business location address is:

1616 S MILITARY TRL
WEST PALM BEACH, FL
ZIP 33415-612
Phone: (561) 968-1234
Fax: (561) 967-9178

The provider's authorized official is Galen Grayson .
The authorized official title is Owner/medical Director and has the following contact phone number (704) 295-0001.

The enumeration date for this NPI number is 8/21/2012 and was last updated on 8/21/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristNo
2207W00000XOphthalmologyNo
3152WC0802XOptometristCorneal and Contact ManagementYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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