Organization
ORLANDO NORTH EYE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALY REZA SHERALY MD (OWNER)
(407) 431-0580
Entity
Organization
Contact information
Practice address
3300 W LAKE MARY BLVD STE 210, LAKE MARY, FL 32746-3499
(407) 431-0580
Mailing address
3300 W LAKE MARY BLVD STE 210, LAKE MARY, FL 32746-3499
(321) 234-7424
(866) 388-3867
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103596500
—
FL
Enumeration date
05/03/2022
Last updated
08/29/2022
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