Provider Demographics
NPI:1487012498
Name:NORTH FLORIDA CATARACT SPECIALISTS AND VISION CARE LLC
Entity Type:Organization
Organization Name:NORTH FLORIDA CATARACT SPECIALISTS AND VISION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:DOY
Authorized Official - Last Name:SNODGRASS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-373-4300
Mailing Address - Street 1:4313 NW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4777
Mailing Address - Country:US
Mailing Address - Phone:352-373-4300
Mailing Address - Fax:352-372-1641
Practice Address - Street 1:4313 NW 8TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4777
Practice Address - Country:US
Practice Address - Phone:352-373-4300
Practice Address - Fax:352-372-1641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4920152W00000X
FLME50106207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01884YMedicare PIN
FLIE831YMedicare PIN
FL20828UMedicare PIN
FL20309WMedicare PIN
FL02963WMedicare PIN
FLIN729AMedicare PIN