Provider Demographics
NPI:1588789572
Name:REEKERS, PAMELA ROSE (OD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:ROSE
Last Name:REEKERS
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 1:514 E WOOLBRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6033
Mailing Address - Country:US
Mailing Address - Phone:561-746-6770
Mailing Address - Fax:561-746-4066
Practice Address - Street 1:175 TONEY PENNA DR
Practice Address - Street 2:STE 102
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-5747
Practice Address - Country:US
Practice Address - Phone:561-746-6770
Practice Address - Fax:561-746-4066
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 1958152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOPC 1958OtherOPTOMETRIC LICENSE NUMBER
FL19894YMedicare PIN
FLOPC 1958OtherOPTOMETRIC LICENSE NUMBER