# FLORIDA EYE AND LASER INSTITUTE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FLORIDA EYE AND LASER INSTITUTE LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1215123831
- **Legal business name:** FLORIDA EYE AND LASER INSTITUTE LLC
- **Authorized official:** DR. JOSEPH A HEGLEH MD (PRESIDENT)
- **Authorized official phone:** (941) 883-2020

## Contact information

- **Practice address:** 3195 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8034
- **Practice address phone:** (941) 883-2020
- **Practice address fax:** (941) 883-3938
- **Mailing address:** 3195 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8034
- **Mailing address phone:** (941) 883-2020
- **Mailing address fax:** (941) 883-3938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 81459 | FL | Yes |

## Other

- **Enumeration date:** 09/18/2007
- **Last updated:** 06/13/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 58829 | BLUE CROSS BLUE SHIELD OF FLORIDA | FL |