Provider Demographics
NPI:1063297356
Name:EYES ON SOUTHERN PLLC
Entity type:Organization
Organization Name:EYES ON SOUTHERN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONKS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:201-983-3783
Mailing Address - Street 1:15589 BENT CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6315
Mailing Address - Country:US
Mailing Address - Phone:201-983-3783
Mailing Address - Fax:
Practice Address - Street 1:11925 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-7629
Practice Address - Country:US
Practice Address - Phone:561-270-5520
Practice Address - Fax:561-270-5530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty