Organization
EYE SPECIALISTS LASER & SURGERY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S GOROVOY M.D. (MEDICAL DOCTOR/PRESIDENT)
(239) 939-1444
Entity
Organization
Contact information
Practice address
12453 S CLEVELAND AVE, FORT MYERS, FL 33907-3828
(239) 939-1444
(239) 275-3332
Mailing address
12453 S CLEVELAND AVE, FORT MYERS, FL 33907-3828
(239) 939-1444
(239) 275-3332
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003297700
—
FL
01
—
1508182577
UNITED HEALTHCARE
FL
01
—
6CG
BC/BS
FL
01
—
F1554
MEDICARE
FL
01
—
P00936589
RR MEDICARE
FL
Enumeration date
04/15/2010
Last updated
08/26/2011
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