Healthcare Provider Details

I. General information

NPI: 1942263918
Provider Name (Legal Business Name): FLORIDA EYE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 9TH AVE N
ST PETERSBURG FL
33705
US

IV. Provider business mailing address

1515 9TH AVE N
ST PETERSBURG FL
33705
US

V. Phone/Fax

Practice location:
  • Phone: 727-895-2020
  • Fax: 727-823-8796
Mailing address:
  • Phone: 727-895-2020
  • Fax: 727-823-8796

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. MARK A SIBLEY
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 727-895-2020