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Organization
VITREO RETINAL SURGEONS LLC
Active
Organization
VITREO RETINAL SURGEONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS G WARD DO (PHYSICIAN SURGEON OWNER)
(352) 597-2604
Entity
Organization
Contact information
Practice address
11373 CORTEZ BLVD, STE 400, BROOKSVILLE, FL 34613-5414
(352) 597-2604
(352) 596-0520
Mailing address
11373 CORTEZ BLVD, STE 400, BROOKSVILLE, FL 34613-5414
(352) 597-2604
(352) 596-0520
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
OS04712
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371161700
—
FL
Enumeration date
10/19/2005
Last updated
09/15/2008
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