# ISLAND CITY EYECARE LLC

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

## Provider details

- **NPI number:** 1649446097
- **Authorized official:** SANDRA BRAUSS (SECRETARY)
- **Authorized official phone:** (954) 764-6906

## Contact information

- **Practice address:** 2301 WILTON DR, UNIT C1, WILTON MANORS, FL 33305-1202
- **Practice address phone:** (954) 764-6906
- **Practice address fax:** (954) 463-7933
- **Mailing address:** 2301 WILTON DR, UNIT C1, WILTON MANORS, FL 33305-1202
- **Mailing address phone:** (954) 764-6906
- **Mailing address fax:** (954) 463-7933

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC001072 | FL | Yes |

## Other

- **Enumeration date:** 05/06/2008
- **Last updated:** 05/07/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000J1 | BCBS | FL |
| 05 | — | 078966600 | — | FL |
| 05 | — | 084758500 | — | FL |
| 01 | — | 19523 | BLUE CROSS BLUE SHIELD | FL |
| 01 | — | 20512 | BCBS | FL |
| 01 | — | 220833 | AVMED | FL |
| 01 | — | 321773 | AVMED | FL |
| 01 | — | 3446264 | AETNA | FL |
| 05 | — | 621354500 | — | FL |
| 01 | — | 6374970001 | DMERC CIGNA | FL |