Provider Demographics
NPI:1225341134
Name:SIGHTTRUST EYE INSTITUTE, P.A.
Entity Type:Organization
Organization Name:SIGHTTRUST EYE INSTITUTE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SHATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-653-0100
Mailing Address - Street 1:1601 SAWGRASS CORPORATE PKWY STE 430
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2827
Mailing Address - Country:US
Mailing Address - Phone:954-653-0100
Mailing Address - Fax:954-607-5977
Practice Address - Street 1:1601 SAWGRASS CORPORATE PKWY STE 430
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323
Practice Address - Country:US
Practice Address - Phone:954-835-0800
Practice Address - Fax:954-607-5977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-20
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106417207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty