Basic Information
| Provider Information | |||||||||
| NPI: | 1588726640 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DREXLER EYE CARE ASSOCIATES, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2551 DREW ST. | ||||||||
| Address2: | SUITE #302 | ||||||||
| City: | CLEARWATER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 33765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7277911214 | ||||||||
| FaxNumber: | 7277910597 | ||||||||
| Practice Location | |||||||||
| Address1: | 2551 DREW ST. | ||||||||
| Address2: | SUITE #302 | ||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7277911214 | ||||||||
| FaxNumber: | 7277910597 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2006 | ||||||||
| LastUpdateDate: | 06/17/2008 | ||||||||
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| AuthorizedOfficialLastName: | DREXLER | ||||||||
| AuthorizedOfficialFirstName: | SHEILA | ||||||||
| AuthorizedOfficialMiddleName: | D. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7277911214 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | O.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2235 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 620067200 | 05 | FL | MEDICAID |