Healthcare Provider Details

I. General information

NPI: 1497277727
Provider Name (Legal Business Name): FLORIDA EYE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 07/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 MALABAR RD NE
PALM BAY FL
32907-3092
US

IV. Provider business mailing address

502 E NEW HAVEN AVE
MELBOURNE FL
32901-5427
US

V. Phone/Fax

Practice location:
  • Phone: 321-727-2020
  • Fax: 321-984-9547
Mailing address:
  • Phone: 321-727-2020
  • Fax: 321-984-9547

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. RALPH R PAYLOR
Title or Position: PRESIDENT
Credential: MD
Phone: 321-727-2020