Provider Demographics
NPI:1538231626
Name:BAWANEY, MISSBA (OD)
Entity type:Individual
Prefix:DR
First Name:MISSBA
Middle Name:
Last Name:BAWANEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MB EYECARE, LLC
Mailing Address - Street 2:8990 TURKEY LAKE ROAD
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8990 TURKEY LAKE ROAD
Practice Address - Street 2:MB EYECARE, LLC
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:847-677-7202
Practice Address - Fax:847-677-1258
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL46009886152W00000X
IL046009886152W00000X
FLOPC4197152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist