Healthcare Provider Details

I. General information

NPI: 1891735411
Provider Name (Legal Business Name): EYE PHYSICIANS OF CENTRAL FLORIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 MORAY LANE
WINTER PARK FL
32792
US

IV. Provider business mailing address

249 MORAY LN
WINTER PARK FL
32792-4122
US

V. Phone/Fax

Practice location:
  • Phone: 407-645-4350
  • Fax: 407-767-8160
Mailing address:
  • Phone: 407-645-4350
  • Fax: 407-645-0337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. CHARLA FERCHOW
Title or Position: ADMINISTRATOR
Credential:
Phone: 407-767-6411