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Organization

COMMUNITY EYE OPTICAL LC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. HOLLY MCKAY BURNETTE (PRACTICE ADMINISTRATOR)
(941) 625-1325
Entity
Organization

Contact information

Practice address
2825 TAMIAMI TRL, BLDG. B SUITE 3 & 4, PUNTA GORDA, FL 33950-7269
(941) 347-8346
(941) 347-8326
Mailing address
2825 TAMIAMI TRL, BLDG. B SUITE 3 & 4, PUNTA GORDA, FL 33950-7269
(941) 347-8346
(941) 347-8326

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
79133
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4769100005
PTAN
Enumeration date
04/07/2010
Last updated
04/05/2011
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