Organization
MONTGOMERY EYE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARIANA BEDOYA (CREDENTIALING SPECIALIST)
(727) 755-0693
Entity
Organization
Contact information
Practice address
8403 BRYANT ST, WESTMINSTER, CO 80031-3809
(727) 755-0693
Mailing address
311 PARK PLACE BLVD, SUITE 500, CLEARWATER, FL 33759-4904
(727) 755-0693
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
DR0039792
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64170225
—
CO
Enumeration date
02/09/2016
Last updated
02/09/2016
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