Provider Demographics
NPI:1508942806
Name:CENTRAL FLORIDA EYE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CENTRAL FLORIDA EYE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VAHIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-896-8990
Mailing Address - Street 1:1900 N ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5531
Mailing Address - Country:US
Mailing Address - Phone:407-896-8990
Mailing Address - Fax:407-896-6034
Practice Address - Street 1:1900 N ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5531
Practice Address - Country:US
Practice Address - Phone:407-896-8990
Practice Address - Fax:407-896-6034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-29
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96638207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ0558Medicare PIN