Provider Demographics
NPI:1467497529
Name:FLORIDA EYE & PLASTIC SURGERY ASSOCIATES INC
Entity Type:Organization
Organization Name:FLORIDA EYE & PLASTIC SURGERY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIRTAZ
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:SIBIA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-752-0075
Mailing Address - Street 1:10075 JOG RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3535
Mailing Address - Country:US
Mailing Address - Phone:561-752-0075
Mailing Address - Fax:
Practice Address - Street 1:10075 JOG RD
Practice Address - Street 2:SUITE 301
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3535
Practice Address - Country:US
Practice Address - Phone:561-752-0075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL49882OtherBCBS
FL49882OtherBCBS
FLK3196Medicare ID - Type Unspecified