MEDICARE: ST. CROIX EYE GROUP, INC.

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	207W00000X	Ophthalmology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528156817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. CROIX EYE GROUP, INC.

Provider Business Mailing Address
First Line	:	PO BOX 3019
Second Line	:
City	:	KINGSHILL
State	:	VI
Zip	:	00851-3019
Country	:	US
Telephone Number	:	340-773-2015
Fax Number	:	340-719-9590

Provider Business Practice Location Address
First Line	:	4500 SUNNY ISLE
Second Line	:	ISLAND MEDICAL CENTER
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4493
Country	:	US
Telephone Number	:	340-773-2015
Fax Number	:	340-719-9590

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALFRED L ANDUZE
Credential	:	M.D.
Telephone Number	:	340-773-2015

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	08/22/2020

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Directions to “ST. CROIX EYE GROUP, INC. ” Practice Location

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