Provider Demographics
NPI:1588429211
Name:LC EYECARE INC
Entity type:Organization
Organization Name:LC EYECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-772-9565
Mailing Address - Street 1:2623 SW 4TH LN
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-1118
Mailing Address - Country:US
Mailing Address - Phone:305-772-9565
Mailing Address - Fax:
Practice Address - Street 1:18500 VETERANS BLVD UNIT 4
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954-1035
Practice Address - Country:US
Practice Address - Phone:941-743-7449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty