| Eyedata - Eye Doctors And Technology Advantage | |
|
410 S Washington St Falls Church VA 22046-4412 | |
| (703) 532-0728 | |
| Not Available |
| Full Name | Eyedata - Eye Doctors And Technology Advantage |
|---|---|
| Speciality | Ophthalmology |
| Location | 410 S Washington St, Falls Church, Virginia |
| Authorized Official Name and Position | Gustavo Adolfo Corrales Regalado (DIRECTOR) |
| Authorized Official Contact | 3013355860 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eyedata - Eye Doctors And Technology Advantage 410 S Washington St Falls Church VA 22046-4412 Ph: (703) 532-0728 | Eyedata - Eye Doctors And Technology Advantage 410 S Washington St Falls Church VA 22046-4412 Ph: (703) 532-0728 |
| NPI Number | 1013358514 |
|---|---|
| Provider Enumeration Date | 07/12/2013 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 0244469559 |
|---|---|
| Medicare Enrollment ID | O20140208000106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013358514 | NPI | - | NPPES |
| A400003148 | Other | MD | MEDICARE PROVIDER NUMBER |
| Provider Name | Jorge L Campana |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1811981483 PECOS PAC ID: 6901989524 Enrollment ID: I20091124000309 |
| Provider Name | Gustavo A Corrales |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1326249889 PECOS PAC ID: 0143388421 Enrollment ID: I20100602000047 |
| Provider Name | Diana Carolina Salazar Vega |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1790307551 PECOS PAC ID: 7214351626 Enrollment ID: I20211015001310 |
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