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NPI Code Detail

MEDICARE: FLORIDA EYE INSTITUTE SURGICENTER LLC

MEDICARE: FLORIDA EYE INSTITUTE SURGICENTER 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
1261QA1903XAmbulatory Surgical Clinic/Center859FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00055069OTHERFLRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3663OTHERFLFL BCBS NO.

General Provider Information

NPI Number : 1598700676
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA EYE INSTITUTE SURGICENTER LLC
Provider Business Mailing Address
First Line : 2750 INDIAN RIVER BLVD
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-5225
Country : US
Telephone Number : 772-569-9500
Fax Number : 772-569-9507
Provider Business Practice Location Address
First Line : 2750 INDIAN RIVER BLVD
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-5225
Country : US
Telephone Number : 772-569-9500
Fax Number : 772-569-9507
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. MARY LYNNE MACDONALD
Credential :
Telephone Number : 772-569-9500
Provider Enumeration Date : 06/20/2006
Last Update Date : 06/07/2024

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Directions to “FLORIDA EYE INSTITUTE SURGICENTER LLC ” Practice Location

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