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General NPI Number Information
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NPI Number | 1447279369
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Entity Type | Organization
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Legal Business Name | EYE CENTER OF NORTH FLORIDA, P.A.
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 2500 MARTIN LUTHER KING JR BLVD
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City | PANAMA CITY
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State | FL
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Zip | 32405-4412
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Country | US
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Telephone | 850-784-3937
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Fax | 850-522-9829
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Provider Business Mailing Address
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Address Line | 2500 MARTIN LUTHER KING JR BLVD
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City | PANAMA CITY
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State | FL
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Zip | 32405-4412
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Country | US
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Telephone | 850-784-3937
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Fax | 850-522-9829
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. BRET L FISHER
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Credential | M.D.
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Telephone | 850-784-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 1099
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License Number State | FL
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