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General NPI Number Information
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NPI Number | 1730284118
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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 | 09/13/2006
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 10900 HUTCHISON BLVD
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-3712
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Country | US
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Telephone | 850-234-1829
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Fax | 850-233-5493
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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 | 850-522-9839
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. KATHI NICHOLS
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Credential |
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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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 | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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