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General NPI Number Information
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NPI Number | 1558475400
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Entity Type | Organization
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Legal Business Name | FORT LAUDERDALE EYE INSTITUTE
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 850 S PINE ISLAND RD SUITE A100
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City | PLANTATION
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State | FL
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Zip | 33324-3118
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Country | US
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Telephone | 954-741-5555
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Fax | 954-572-9658
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Provider Business Mailing Address
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Address Line | PO BOX 39209
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City | FT LAUDERDALE
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State | FL
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Zip | 33339-9209
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Country | US
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Telephone | 954-741-5555
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Fax | 954-572-9658
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Authorized Official
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Title or Position | OWNER
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Name | KEITH SKOLNICK
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Credential | M.D.
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Telephone | 954-741-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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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 |
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License Number State | FL
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