# FLORIDA OPHTHALMIC AFFILIATES, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689921389
- **Authorized official:** DAVID MICHAEL MILLS MD (OWNER)
- **Authorized official phone:** (855) 989-2020

## Contact information

- **Practice address:** 1300 SHORELINE DRIVE, SUITE 104, GULF BREEZE, FL 32561-4766
- **Practice address phone:** (855) 989-2020
- **Practice address fax:** (855) 290-5952
- **Mailing address:** 348 MIRACLE STRIP PKWY SW, SUITE 38, FORT WALTON BEACH, FL 32548-5200
- **Mailing address phone:** (855) 989-2020
- **Mailing address fax:** (855) 989-2020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME85614 | FL | Yes |
| 2086S0122X | Plastic and Reconstructive Surgery Physician | ME85614 | FL | — |

## Other

- **Enumeration date:** 08/13/2012
- **Last updated:** 07/16/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 006482200 | — | FL |
| 05 | — | 006482201 | — | FL |