Provider Demographics
NPI:1023249927
Name:BRITNEY CARUSO OD PA
Entity type:Organization
Organization Name:BRITNEY CARUSO OD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITNEY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARUSO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:847-507-0720
Mailing Address - Street 1:350 SE 2ND ST APT 2750
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1956
Mailing Address - Country:US
Mailing Address - Phone:847-507-0720
Mailing Address - Fax:
Practice Address - Street 1:6000 GLADES RD STE 1040
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7221
Practice Address - Country:US
Practice Address - Phone:561-368-5065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2010-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3877152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU5799ZMedicare PIN