Provider Demographics
NPI:1134325046
Name:APPLE OPHTHALMIC PA
Entity Type:Organization
Organization Name:APPLE OPHTHALMIC PA
Other - Org Name:STOLTE EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:B
Authorized Official - Last Name:STOLTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-568-2020
Mailing Address - Street 1:11115 COUNTY LINE ROAD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5615
Mailing Address - Country:US
Mailing Address - Phone:352-666-9990
Mailing Address - Fax:352-666-1905
Practice Address - Street 1:1310 NORTH C-470
Practice Address - Street 2:
Practice Address - City:LAKE PANASOFFKEE
Practice Address - State:FL
Practice Address - Zip Code:33538
Practice Address - Country:US
Practice Address - Phone:352-568-2020
Practice Address - Fax:352-666-1905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43218207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLB26712Medicare UPIN
FL12218CMedicare ID - Type Unspecified