Provider Demographics
NPI:1407906159
Name:ASSOCIATED COMPREHENSIVE EYECARE P A
Entity Type:Organization
Organization Name:ASSOCIATED COMPREHENSIVE EYECARE P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDER
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:WINGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-732-8404
Mailing Address - Street 1:2441 SE FORT KING ST BLDG 100
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2558
Mailing Address - Country:US
Mailing Address - Phone:352-732-8404
Mailing Address - Fax:352-732-0177
Practice Address - Street 1:2441 SE FORT KING ST BLDG 100
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2558
Practice Address - Country:US
Practice Address - Phone:352-732-8404
Practice Address - Fax:352-732-0177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC002774152W00000X
FLME0028326207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000062100Medicaid
FL0004BOtherBCBS FLORIDA
FLAL157Medicare PIN