| |
27 Us 27 S, Lake Placid, FL 33852-7916 | |
(863) 465-4904 | |
(863) 465-4650 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 27 Us 27 S, Lake Placid, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649342767 | NPI | - | NPPES |
19418 | Other | FL | BCBS OF FL |
CM2511 | Other | FL | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Florida) | Primary |
Mailing Address | Practice Location Address |
---|---|
27 Us 27 S, Lake Placid, FL 33852-7916 Ph: (863) 465-4904 | 27 Us 27 S, Lake Placid, FL 33852-7916 Ph: (863) 465-4904 |
Dr. Glenn R Thayer, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 27 Us 27 S, Lake Placid, FL 33852 Phone: 863-465-4904 Fax: 863-465-4650 |