Provider Demographics
NPI:1154892990
Name:YARABU EYE CARE, P.A.
Entity type:Organization
Organization Name:YARABU EYE CARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:LASCAIBAR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:941-567-4675
Mailing Address - Street 1:11523 PALMBRUSH TRL # 124
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-2917
Mailing Address - Country:US
Mailing Address - Phone:941-567-4675
Mailing Address - Fax:
Practice Address - Street 1:1141 53RD AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207-2858
Practice Address - Country:US
Practice Address - Phone:941-567-4675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005809800Medicaid