Provider Demographics
NPI:1386658110
Name:PROFESSIONAL EYE CARE CONSULTANTS
Entity type:Organization
Organization Name:PROFESSIONAL EYE CARE CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-557-9004
Mailing Address - Street 1:285 W 74TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5058
Mailing Address - Country:US
Mailing Address - Phone:305-557-9004
Mailing Address - Fax:305-362-2885
Practice Address - Street 1:285 W 74TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5058
Practice Address - Country:US
Practice Address - Phone:305-557-9004
Practice Address - Fax:305-362-2885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1156152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========Medicare UPIN