Organization
ISLAND CITY EYECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA BRAUSS (SECRETARY)
(954) 764-6906
Entity
Organization
Contact information
Practice address
2301 WILTON DR, UNIT C1, WILTON MANORS, FL 33305-1202
(954) 764-6906
(954) 463-7933
Mailing address
2301 WILTON DR, UNIT C1, WILTON MANORS, FL 33305-1202
(954) 764-6906
(954) 463-7933
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC001072
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000J1
BCBS
FL
05
—
078966600
—
FL
05
—
084758500
—
FL
01
—
19523
BLUE CROSS BLUE SHIELD
FL
01
—
20512
BCBS
FL
01
—
220833
AVMED
FL
01
—
321773
AVMED
FL
01
—
3446264
AETNA
FL
05
—
621354500
—
FL
01
—
6374970001
DMERC CIGNA
FL
Enumeration date
05/06/2008
Last updated
05/07/2014
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