Organization
EYE MD OF NICEVILLE SURGERY LLC
Active
Parent organization
EYE M.D. OF NICEVILLE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EYE M.D. OF NICEVILLE LLC
Authorized official
MARIA RUTTIG (PRACTICE ADMINISTRATOR)
(703) 489-8720
Entity
Organization
Contact information
Practice address
1480 HICKORY ST STE 106, NICEVILLE, FL 32578-8843
(850) 760-0520
(850) 760-0501
Mailing address
1480 HICKORY ST STE 106, NICEVILLE, FL 32578-8843
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/22/2021
Last updated
02/22/2021
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