Healthcare Provider Details

I. General information

NPI: 1932314473
Provider Name (Legal Business Name): FLORENCE OPHTHALMOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 COX CREEK PKWY STE A
FLORENCE AL
35630-1189
US

IV. Provider business mailing address

646 COX CREEK PKWY STE A
FLORENCE AL
35630-1105
US

V. Phone/Fax

Practice location:
  • Phone: 256-760-1771
  • Fax: 256-766-4713
Mailing address:
  • Phone: 256-760-9149
  • Fax: 256-760-9149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH GIRA
Title or Position: CMO
Credential: MD
Phone: 314-909-0633