Organization
COMMUNITY EYE DISPENSARY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARIANA BEDOYA (CREDENTIALING MANAGER)
(727) 755-0693
Entity
Organization
Contact information
Practice address
21275 OLEAN BLVD, PORT CHARLOTTE, FL 33952-6704
(727) 755-0693
Mailing address
311 PARK PLACE BLVD FL 5, CLEARWATER, FL 33759-4904
(727) 755-0693
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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