Provider Demographics
NPI:1023883360
Name:GRACEFULEYE CARE LLC
Entity type:Organization
Organization Name:GRACEFULEYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGUIB
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-706-2945
Mailing Address - Street 1:3031 W SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-3233
Mailing Address - Country:US
Mailing Address - Phone:954-706-2945
Mailing Address - Fax:
Practice Address - Street 1:3031 W SPRUCE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-3233
Practice Address - Country:US
Practice Address - Phone:954-706-2945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-16
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty