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Organization
FILUTOWSKI EYE INSTITUTE PA
Active
Organization
FILUTOWSKI EYE INSTITUTE PA
Active
Other names
LAKE MARY SURGICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
KONRAD W FILUTOWSKI MD (PRESIDENT AND MEDICAL DIRECTOR)
(407) 333-5111
Entity
Organization
Contact information
Practice address
1070 GREENWOOD BLVD, LAKE MARY, FL 32746-5404
(407) 333-5111
(407) 333-2434
Mailing address
110 YORKTOWNE DR, DAYTONA BEACH, FL 32119-1471
(386) 788-6696
(386) 788-2219
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1054
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0082522
GHI
FL
05
—
0768600 00
—
FL
01
—
10D0928401
CLIA
FL
01
—
68E
BCBSFL
FL
Enumeration date
11/10/2006
Last updated
04/11/2017
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