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General NPI Number Information
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NPI Number | 1407906159
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Entity Type | Organization
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Legal Business Name | ASSOCIATED COMPREHENSIVE EYECARE P A
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 2441 SE FORT KING ST BLDG 100
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City | OCALA
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State | FL
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Zip | 34471-2558
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Country | US
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Telephone | 352-732-8404
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Fax | 352-732-0177
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Provider Business Mailing Address
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Address Line | 2441 SE FORT KING ST BLDG 100
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City | OCALA
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State | FL
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Zip | 34471-2558
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Country | US
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Telephone | 352-732-8404
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Fax | 352-732-0177
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LINDER EARL WINGO
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Credential | M.D.
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Telephone | 352-732-8404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC002774
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME0028326
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License Number State | FL
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