Organization
TAMPA BAY RETINA, PA
Active
Other names
Gulf Coast Retina Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OREN PLOUS MD (PRESIDENT)
(248) 790-5111
Entity
Organization
Contact information
Practice address
1961 FLOYD ST, SUITE B, SARASOTA, FL 34239
(941) 312-2769
(941) 759-6476
Mailing address
1961 FLOYD ST, SUITE B, SARASOTA, FL 34239-2931
(941) 312-2769
(866) 426-2169
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
ME97145
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
91135
BCBS OF FLORIDA
FL
01
—
P01531788
PALMETTO GBA-RAILROAD MEDICARE
FL
Enumeration date
07/13/2012
Last updated
07/14/2022
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