Provider Demographics
NPI:1831372994
Name:FAMILY EYE CARE & VISION THERAPY
Entity type:Organization
Organization Name:FAMILY EYE CARE & VISION THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ-ORWASKY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:941-966-6700
Mailing Address - Street 1:694 S. TAMIAMI TRAIL
Mailing Address - Street 2:
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229-9216
Mailing Address - Country:US
Mailing Address - Phone:941-966-6700
Mailing Address - Fax:941-966-6839
Practice Address - Street 1:694 S. TAMIAMI TRAIL
Practice Address - Street 2:
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-9216
Practice Address - Country:US
Practice Address - Phone:941-966-6700
Practice Address - Fax:941-966-6839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2451152W00000X
FLOPC2204152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620290000Medicaid
FL1831372994Medicare NSC
FL620290000Medicaid