Provider Demographics
NPI:1033858360
Name:EYE CENTER OF NORTH FLORIDA, P.A.
Entity Type:Organization
Organization Name:EYE CENTER OF NORTH FLORIDA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-990-7590
Mailing Address - Street 1:2500 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4412
Mailing Address - Country:US
Mailing Address - Phone:850-784-3937
Mailing Address - Fax:
Practice Address - Street 1:1920 HUNTINGTON RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-4104
Practice Address - Country:US
Practice Address - Phone:850-784-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE CENTER OF NORTH FLORIDA PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-03
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center