Community Eye Center Pa | |
21275 Olean Blvd, Port Charlotte, FL 33952-6704 | |
(941) 625-1325 | |
(941) 625-0131 |
Full Name | Community Eye Center Pa |
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Type | Facility |
Speciality | Ophthalmology |
Location | 21275 Olean Blvd, Port Charlotte, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083613095 | NPI | - | NPPES |
0790681-01 | Medicaid | FL | |
079068101 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 4095 (Florida) | Secondary |
207W00000X | Ophthalmology | 4095 (Florida) | Primary |
332H00000X | Eyewear Supplier | 79133 (Florida) | Secondary |
Provider Name | Prabin C Mishra |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1851361869 PECOS PAC ID: 1557354222 Enrollment ID: I20050808000317 |
Provider Name | Karen M Memoli |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1508965104 PECOS PAC ID: 4082633680 Enrollment ID: I20051114000164 |
Provider Name | Cheryl L Simoneau |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1811950439 PECOS PAC ID: 5395845689 Enrollment ID: I20070716000615 |
Provider Name | Eric R Schaible |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1245238526 PECOS PAC ID: 6901958891 Enrollment ID: I20100626000446 |
Provider Name | Joseph W Spadafora |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1447258256 PECOS PAC ID: 2466365861 Enrollment ID: I20100726000294 |
Provider Name | Jon K Batzer |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1104824473 PECOS PAC ID: 7719011287 Enrollment ID: I20100819000312 |
Provider Name | Boris Ovodenko |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1598813750 PECOS PAC ID: 7113091018 Enrollment ID: I20140728000358 |
Provider Name | Chelsea Piro Spalding |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1790193399 PECOS PAC ID: 2264748466 Enrollment ID: I20150902003014 |
Provider Name | Tyler Roberts |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1346658945 PECOS PAC ID: 6406163906 Enrollment ID: I20150916001170 |
Provider Name | Eric Liss |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1225477748 PECOS PAC ID: 2668779992 Enrollment ID: I20171017003280 |
Provider Name | Travis Tzyh Wei Poh |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1235616848 PECOS PAC ID: 9931451432 Enrollment ID: I20181011000485 |
Mailing Address | Practice Location Address |
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Community Eye Center Pa 21275 Olean Blvd, Port Charlotte, FL 33952-6704 Ph: (941) 625-1325 | Community Eye Center Pa 21275 Olean Blvd, Port Charlotte, FL 33952-6704 Ph: (941) 625-1325 |