Organization
FLORIDA EYE AND LASER INSTITUTE LLC
Active
Parent organization
FLORIDA EYE AND LASER INSTITUTE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FLORIDA EYE AND LASER INSTITUTE LLC
Authorized official
DR. JOSEPH A HEGLEH MD (PRESIDENT)
(941) 883-2020
Entity
Organization
Contact information
Practice address
3195 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8034
(941) 883-2020
(941) 883-3938
Mailing address
3195 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8034
(941) 883-2020
(941) 883-3938
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
81459
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58829
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
09/18/2007
Last updated
06/13/2013
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