Family Eye Care of Palm Coast, Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

OPC 3585 Issued in FL

Legal business name

FAMILY EYE CARE OF PALM COAST, INC

Practice address

4 Office Park Dr
Suite 4
Palm Coast, FL 32137-3855

Phone

(386) 225-4553

Fax

(386) 225-4558

NPI assigned

Aug 1, 2014

Last updated

Aug 1, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bonnie M Chalker, O.D.

Title

Owner

Phone

(386) 225-4553

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1871901934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OFFICE PARK DR",
            "address_2": "SUITE 4",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373855",
            "telephone_number": "386-225-4553",
            "fax_number": "386-225-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 OFFICE PARK DR",
            "address_2": "SUITE 4",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373855",
            "telephone_number": "386-225-4553",
            "fax_number": "386-225-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE OF PALM COAST, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-01",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "CHALKER",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-225-4553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "OPC 3585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1316998529",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000095900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Faithangel Corp
• Joel Robert Fallon
• Kayleigh Fallon, APRN
• Kelsea Fallon
• Family Care of Palm Coast PA
• Family First Coaching, LLC
• Family Medical Care of Palm Coast LLC
• Waleed Farahat, FNP-C
• Yasser Farahat
• Tania Faria

• Health Service Clinic/Center in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.