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General NPI Number Information
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NPI Number | 1689898868
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Entity Type | Organization
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Legal Business Name | RETINA ASSOCIATES OF CORAL SPRINGS, P.A.
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 1881 N UNIVERSITY DR SUITE 112
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8915
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Country | US
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Telephone | 954-755-4633
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Fax | 954-755-4637
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Provider Business Mailing Address
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Address Line | 1881 N UNIVERSITY DR SUITE 112
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-8915
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Country | US
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Telephone | 954-755-4633
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Fax | 954-755-4637
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEON ALBERT BYNOE
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Credential | M.D.
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Telephone | 954-755-4633
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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 | 0600049327
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License Number State | FL
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