Boone, Eric Brandon

Boone, Eric Brandon is an individual health care provider with primary practice located at 1615 Sw Main Blvd , Lake City FL 32025-1108. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Boone, Eric Brandon can be contacted via phone (386) 755-2785.

Contact Information

Primary practice address
1615 Sw Main Blvd Lake City FL 32025-1108
Fax: (386) 755-1128
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPC3872 Florida
Eye and Vision Services Providers / Optometrist 152W00000X OB3178 Florida

Profile Details

NPI number 1437188562
LBN Legal business name Boone, Eric Brandon
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2006
Last updated Mar 21st, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437188562 NPPES
Other P00188323 RAILROAD MEDICARE
MEDICAID 620976901 RAILROAD MEDICARE
MEDICAID 620976900 RAILROAD MEDICARE
Other 7952763 RAILROAD MEDICARE
Other 1180560001 RAILROAD MEDICARE
MEDICAID 001933700 RAILROAD MEDICARE
Other 25001 RAILROAD MEDICARE
Other 298000 RAILROAD MEDICARE

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