Provider Demographics
NPI:1902931975
Name:EYECARE ASSOCIATES OF VA, P.C.
Entity Type:Organization
Organization Name:EYECARE ASSOCIATES OF VA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-557-9004
Mailing Address - Street 1:285 W 74TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5058
Mailing Address - Country:US
Mailing Address - Phone:305-557-9004
Mailing Address - Fax:305-362-2885
Practice Address - Street 1:11591 W. BROAD ST.
Practice Address - Street 2:STE C
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1186
Practice Address - Country:US
Practice Address - Phone:804-364-0823
Practice Address - Fax:804-364-6376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000756152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty