Provider Demographics
NPI:1629272265
Name:PARK AVENUE OPHTHALMICS, PLLC
Entity type:Organization
Organization Name:PARK AVENUE OPHTHALMICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-893-8200
Mailing Address - Street 1:1911 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1432
Mailing Address - Country:US
Mailing Address - Phone:407-893-8200
Mailing Address - Fax:407-893-8220
Practice Address - Street 1:2269 E SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5713
Practice Address - Country:US
Practice Address - Phone:407-886-2093
Practice Address - Fax:407-886-9531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4038770001Medicare NSC