Organization
FLORIDA EYE INSTITUTE SURGICENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY LYNNE MACDONALD (ADMINISTRATOR)
(772) 569-9500
Entity
Organization
Contact information
Practice address
2750 INDIAN RIVER BLVD, VERO BEACH, FL 32960-5225
(772) 569-9500
(772) 569-9507
Mailing address
2750 INDIAN RIVER BLVD, VERO BEACH, FL 32960-5225
(772) 569-9500
(772) 569-9507
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
859
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079122900
—
FL
01
—
663
FL BCBS NO.
FL
01
—
P00055069
RR MEDICARE
FL
Enumeration date
06/20/2006
Last updated
06/07/2024
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