Organization
EYE SURGERY CENTER OF SAINT AUGUSTINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL W HUND III M.D. (MEDICAL DIRECTOR)
(904) 829-2344
Entity
Organization
Contact information
Practice address
1400 US HIGHWAY 1 S, ST AUGUSTINE, FL 32084-4211
(904) 829-2344
Mailing address
1400 US HIGHWAY 1 S, ST AUGUSTINE, FL 32084-4211
(904) 829-2344
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
F1416
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075723300
—
FL
01
—
AHCA ID NUMBER
14960504
FL
01
—
BLUE CROSS BLUE SHIE
6G6
FL
01
—
LICENSE NUMBER
1195
FL
Enumeration date
08/15/2005
Last updated
01/17/2013
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