Poland Eye and Laser Center, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

POLAND EYE AND LASER CENTER, LLC

Practice address

14 S Main St
Poland, OH 44514-1914

Phone

(330) 757-1519

Fax

(330) 757-1510

NPI assigned

Sep 25, 2024

Organization subpart

No

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

Authorized official

Name

Nicholas Flebotte

Title

Sole Member

Phone

(860) 394-8579

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1962229369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S MAIN ST",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445141914",
            "telephone_number": "330-757-1519",
            "fax_number": "330-757-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S MAIN ST",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445141914",
            "telephone_number": "330-757-1519",
            "fax_number": "330-757-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLAND EYE AND LASER CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "FLEBOTTE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "860-394-8579"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Poland Imaging
• Poland Local SD
• Poland Medical Center LTD
• Poland Way Assisted Living, LLC

• All providers in Poland, OH
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.