Provider Demographics
NPI:1174703979
Name:BEACH EYE CARE INC
Entity type:Organization
Organization Name:BEACH EYE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:TOSCANO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:386-677-8040
Mailing Address - Street 1:501 PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-3014
Mailing Address - Country:US
Mailing Address - Phone:386-677-8040
Mailing Address - Fax:386-677-8055
Practice Address - Street 1:501 PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32118-3014
Practice Address - Country:US
Practice Address - Phone:386-677-8040
Practice Address - Fax:386-677-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2890152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty