# BLAHNIK EYE CARE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043462914
- **Authorized official:** DR. SUZETTE A BLAHNIK O.D. (PRESIDENT)
- **Authorized official phone:** (386) 492-6999

## Contact information

- **Practice address:** 3740 S RIDGEWOOD AVE, UNIT 103, PORT ORANGE, FL 32129-3510
- **Practice address phone:** (386) 492-6999
- **Practice address fax:** (386) 492-6900
- **Mailing address:** 3740 S RIDGEWOOD AVE, UNIT 103, PORT ORANGE, FL 32129-3510
- **Mailing address phone:** (386) 492-6999
- **Mailing address fax:** (386) 492-6900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC2215 | FL | Yes |

## Other

- **Enumeration date:** 10/22/2008
- **Last updated:** 03/05/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00781100 | — | FL |