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Organization
FLORIDA EYE CLINIC P A
Active
Organization
FLORIDA EYE CLINIC P A
Active
Parent organization
FLORIDA EYE CLINIC P A
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA EYE CLINIC P A
Authorized official
HARRY PAPPAS (ADMINISTRATOR)
(407) 834-7776
Entity
Organization
Contact information
Practice address
1089 W GRANADA BLVD, #4, ORMOND BEACH, FL 32174-8299
(386) 676-1300
(386) 372-5073
Mailing address
160 BOSTON AVE, ALTAMONTE SPRINGS, FL 32701-4706
(407) 339-0303
(407) 339-0961
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
NULL
152W00000X
Optometrist
Primary
—
—
156FX1800X
Optician
—
NULL
156FX1800X
Optician
—
—
207W00000X
Ophthalmology Physician
—
NULL
207W00000X
Ophthalmology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208488110
—
FL
Enumeration date
02/21/2006
Last updated
12/21/2020
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