# EYE SPECIALISTS OF MID FLORIDA, PA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EYE SPECIALISTS OF MID FLORIDA P.A.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588990758
- **Legal business name:** EYE SPECIALISTS OF MID FLORIDA P.A.
- **Authorized official:** DANIEL WELCH M.D. (PRESIDENT)
- **Authorized official phone:** (863) 294-3504

## Contact information

- **Practice address:** 2800 A RIDGE WAY, SUITE 100, LAKE WALES, FL 33859
- **Practice address phone:** (863) 676-2008
- **Practice address fax:** (863) 676-6638
- **Mailing address:** 407 AVENUE K SE, WINTER HAVEN, FL 33880-4126
- **Mailing address phone:** (863) 294-3504
- **Mailing address fax:** (863) 299-0096

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME32357 | FL | Yes |

## Other

- **Enumeration date:** 10/23/2009
- **Last updated:** 03/12/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0585110002 | DMERC | — |