Provider Demographics
NPI:1902580459
Name:SUNSET EYE CARE LLC
Entity Type:Organization
Organization Name:SUNSET EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-418-6170
Mailing Address - Street 1:900 N BELCHER RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765
Mailing Address - Country:US
Mailing Address - Phone:317-418-6170
Mailing Address - Fax:727-449-0616
Practice Address - Street 1:900 N BELCHER RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-2105
Practice Address - Country:US
Practice Address - Phone:727-447-5466
Practice Address - Fax:727-449-0616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier