# ATLANTIC EYE INSTITUTE P.A.

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

## Provider details

- **NPI number:** 1720894819
- **Authorized official:** CANDICE B DAVIS (CHIEF REVENUE CYCLE OFFICER)
- **Authorized official phone:** (916) 990-7590

## Contact information

- **Practice address:** 105 NATURE WALK PKWY UNIT 105, ST AUGUSTINE, FL 32092-4903
- **Practice address phone:** (904) 241-7865
- **Practice address fax:** (904) 421-7435
- **Mailing address:** 3316 3RD ST S STE 103, JACKSONVILLE BEACH, FL 32250-6090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 12/04/2024
- **Last updated:** 12/04/2024