Organization
TREASURE COAST EYE ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRICE A ROSELLI O.D. (OWNER)
(772) 978-0845
Entity
Organization
Contact information
Practice address
333 17TH ST, STE. G, VERO BEACH, FL 32960-5670
(772) 978-0845
Mailing address
333 17TH ST, STE. G, VERO BEACH, FL 32960-5670
(772) 978-0845
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
OPC 3612
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K4154
MEDICARE GROUP #
FL
Enumeration date
08/14/2007
Last updated
08/14/2007
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