| Beach Vision Holdings, Pa | |
|
103 Faulkner St, New Smyrna Beach, FL 32168-7017 | |
| (396) 423-7788 | |
| (386) 423-0035 |
| Full Name | Beach Vision Holdings, Pa |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 103 Faulkner St, New Smyrna Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346516747 | NPI | - | NPPES |
| 078276900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | OPC 1689 (Florida) | Primary |
| Provider Name | Susan Simpson Sullenberger |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700092350 PECOS PAC ID: 1254328321 Enrollment ID: I20120410000513 |
| Provider Name | Charles D Register |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053493361 PECOS PAC ID: 1557579893 Enrollment ID: I20120418000368 |
| Provider Name | Kevin Bruce Brantley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720123490 PECOS PAC ID: 0345237418 Enrollment ID: I20130314000176 |
| Mailing Address | Practice Location Address |
|---|---|
| Beach Vision Holdings, Pa 103 Faulkner St, New Smyrna Beach, FL 32168-7017 Ph: (396) 423-7788 | Beach Vision Holdings, Pa 103 Faulkner St, New Smyrna Beach, FL 32168-7017 Ph: (396) 423-7788 |
Volusia Vision Optometrist Medicare: Not Enrolled in Medicare Practice Location: 641 Middlebury Loop, New Smyrna Beach, FL 32168 Phone: 407-353-9656 | |
Charles D Register, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 103 Faulkner St, New Smyrna Beach, FL 32168 Phone: 386-423-7788 Fax: 386-423-0035 | |
Nsb Eye Inc Optometrist Medicare: Medicare Enrolled Practice Location: 406 Palmetto St Ste A, New Smyrna Beach, FL 32168 Phone: 386-747-2867 | |
Justin Wayne Knuckles, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 415 N Causeway, New Smyrna Beach, FL 32169 Phone: 386-427-4143 Fax: 386-410-2074 | |
Nicola Granger, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 524 Canal St, New Smyrna Beach, FL 32168 Phone: 386-423-5190 | |
Chelsea Elyse Heck, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 415 N Causeway, New Smyrna Beach, FL 32169 Phone: 386-427-4143 |