Provider Demographics
NPI:1700933397
Name:DOCTORS OPTICAL
Entity type:Organization
Organization Name:DOCTORS OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-567-5000
Mailing Address - Street 1:2175 20TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-3024
Mailing Address - Country:US
Mailing Address - Phone:772-567-5000
Mailing Address - Fax:772-770-3485
Practice Address - Street 1:2175 20TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-3024
Practice Address - Country:US
Practice Address - Phone:772-567-5000
Practice Address - Fax:772-770-3485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOE 1332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0694020001Medicare NSC