# PREMIERMED OPHTHALMOLOGY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154089332
- **Authorized official:** DR. GARY VISSER MD (MANAGING MEMBER)
- **Authorized official phone:** (407) 581-9065

## Contact information

- **Practice address:** 1291 WINTER GARDEN VINELAND RD STE 130, WINTER GARDEN, FL 34787-6705
- **Practice address phone:** (407) 501-7100
- **Practice address fax:** (407) 501-7200
- **Mailing address:** 1291 WINTER GARDEN VINELAND RD STE 130, WINTER GARDEN, FL 34787-6705
- **Mailing address phone:** (407) 501-7100
- **Mailing address fax:** (407) 501-7200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/03/2021
- **Last updated:** 12/18/2023