| Organization Name: | EYES OF PALM HARBOR |
| NPI Number: | 1053596619 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY HAMMER (PRESIDENT) |
| Mailing Address: | 36163 E Lake Rd Palm Harbor |
| State: | FL US |
| Postal Code: | 346853142 |
| Phone Number: | 7277872645 |
| Fax Number: | 7277872680 |
| NPI Enumeration Date: | 01/02/2008 |
| NPI Last Update Date: | 01/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | DO2953 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |