Provider Demographics
NPI:1003856782
Name:EYE PHYSICIANS OF CENTRAL FLORIDA
Entity Type:Organization
Organization Name:EYE PHYSICIANS OF CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERCHOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-767-6411
Mailing Address - Street 1:1781 PARK CENTER DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6254
Mailing Address - Country:US
Mailing Address - Phone:407-398-7730
Mailing Address - Fax:407-398-7740
Practice Address - Street 1:1781 PARK CENTER DR
Practice Address - Street 2:SUITE 220
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6254
Practice Address - Country:US
Practice Address - Phone:407-398-7730
Practice Address - Fax:407-398-7740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7982187OtherAETNA
FL97664OtherBLUE CROSS
FL7982187OtherAETNA
FL97664AMedicare PIN
FLCB8207Medicare PIN