Provider Demographics
NPI:1679712343
Name:EYE-SITE TOO
Entity type:Organization
Organization Name:EYE-SITE TOO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:FLESHER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-966-2212
Mailing Address - Street 1:7107 LAKE WORTH RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2906
Mailing Address - Country:US
Mailing Address - Phone:561-966-2212
Mailing Address - Fax:561-966-2215
Practice Address - Street 1:7107 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2906
Practice Address - Country:US
Practice Address - Phone:561-966-2212
Practice Address - Fax:561-966-2215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2274332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0765780001OtherDMERC
FLFL2274OtherMISC INSURANCE
FLE99371Medicare UPIN
FL0765780001OtherDMERC