Organization
LAKEFRONT EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL MARGARET BERT O.D. (OPTOMETRIST/OWNER)
(303) 578-8055
Entity
Organization
Contact information
Practice address
1931 SHERIDAN BLVD, SUITE S, EDGEWATER, CO 80214-1316
(303) 578-8055
Mailing address
1931 SHERIDAN BLVD, SUITE S, EDGEWATER, CO 80214-1316
(303) 508-8055
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT.0003048
CO
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPT.0003048
CO
152WL0500X
Low Vision Rehabilitation Optometrist
OPT.0003048
CO
152WP0200X
Pediatric Optometrist
OPT.0003048
CO
152WS0006X
Sports Vision Optometrist
OPT.0003048
CO
152WV0400X
Vision Therapy Optometrist
OPT.0003048
CO
152WX0102X
Occupational Vision Optometrist
OPT.0003048
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046010461
—
IL
05
—
63605376
—
CO
Enumeration date
08/03/2015
Last updated
08/03/2015
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