Provider Demographics
NPI:1730171430
Name:GLASS VISION ASSOCIATES, P.A.
Entity type:Organization
Organization Name:GLASS VISION ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-391-2362
Mailing Address - Street 1:1001 SW 2ND AVE
Mailing Address - Street 2:#4000
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-7245
Mailing Address - Country:US
Mailing Address - Phone:561-391-2362
Mailing Address - Fax:561-391-3012
Practice Address - Street 1:1001 SW 2ND AVE
Practice Address - Street 2:#4000
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-7245
Practice Address - Country:US
Practice Address - Phone:561-391-2362
Practice Address - Fax:561-391-3012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0804910001OtherCIGNA GOVERNMENT SERVICES
FL0804910001OtherCIGNA GOVERNMENT SERVICES
FL0804910001Medicare NSC