MEDICARE: EYE SURGERY ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1023705662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE SURGERY ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	300 S PARK RD STE 300
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-8353
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7593 W BOYNTON BEACH BLVD STE 280
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-6163
Country	:	US
Telephone Number	:	954-431-2777
Fax Number	:	954-431-1856

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GEORGE L NEAL
Credential	:
Telephone Number	:	469-214-0144

Provider Enumeration Date	:	04/24/2023
Last Update Date	:	04/24/2023

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