# BALDWIN PARK EYE CARE PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Baldwin Park Eye Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780190561
- **Authorized official:** DR. ALIASGHAR MEHEBOOB JAGANI OD (PRESIDENT)
- **Authorized official phone:** (407) 979-4829

## Contact information

- **Practice address:** 4829 NEW BROAD ST, ORLANDO, FL 32814-6629
- **Practice address phone:** (407) 979-4829
- **Practice address fax:** (407) 369-4250
- **Mailing address:** 4829 NEW BROAD ST, ORLANDO, FL 32814-6629

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 12/15/2017
- **Last updated:** 12/12/2019