Provider Demographics
NPI:1528332954
Name:NATURAL EYES OF WESTON, LLC
Entity type:Organization
Organization Name:NATURAL EYES OF WESTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:352-615-2076
Mailing Address - Street 1:2863 EXECUTIVE PARK DR.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3645
Mailing Address - Country:US
Mailing Address - Phone:954-217-2992
Mailing Address - Fax:
Practice Address - Street 1:2863 EXECUTIVE PARK DR.
Practice Address - Street 2:SUITE 103
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3645
Practice Address - Country:US
Practice Address - Phone:954-217-2992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4407152W00000X
FLOPC 4414152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty