Healthcare Provider Details

I. General information

NPI: 1396335147
Provider Name (Legal Business Name): GARAY EYE CARE AND SURGERY CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2021
Last Update Date: 01/25/2021
Certification Date: 01/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 OUTER RD
ORLANDO FL
32814-6652
US

IV. Provider business mailing address

812 PALM COVE DR
ORLANDO FL
32835-8048
US

V. Phone/Fax

Practice location:
  • Phone: 407-644-4477
  • Fax:
Mailing address:
  • Phone: 808-829-1341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LESLIE GARAY
Title or Position: OWNER
Credential: MD
Phone: 808-829-1341