Provider Demographics
NPI:1215272653
Name:FAMILY EYE CENTER, INC.
Entity type:Organization
Organization Name:FAMILY EYE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MASSIMO
Authorized Official - Middle Name:R
Authorized Official - Last Name:GRAMANZINI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-423-8444
Mailing Address - Street 1:12220 W SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2233
Mailing Address - Country:US
Mailing Address - Phone:954-423-8444
Mailing Address - Fax:
Practice Address - Street 1:12220 W SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33323-2233
Practice Address - Country:US
Practice Address - Phone:954-423-8444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHB152AMedicare PIN