Organization
EVANS TELEOPTOMETRIC SERVICE FL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA BASILE (MANAGER OF OPEN DOCTOR PANEL)
(516) 243-8708
Entity
Organization
Contact information
Practice address
1270 SAXON BLVD STE 105, ORANGE CITY, FL 32763-8418
(386) 774-5000
Mailing address
1270 SAXON BLVD STE 105, ORANGE CITY, FL 32763-8418
(863) 774-5000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
06/07/2021
Last updated
06/28/2021
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