Provider Demographics
NPI:1538464557
Name:CENTRAL FLORIDA EYES
Entity Type:Organization
Organization Name:CENTRAL FLORIDA EYES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:FELICIANO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:407-359-8016
Mailing Address - Street 1:171 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9027
Mailing Address - Country:US
Mailing Address - Phone:407-359-8016
Mailing Address - Fax:407-359-4129
Practice Address - Street 1:171 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9027
Practice Address - Country:US
Practice Address - Phone:407-359-8016
Practice Address - Fax:407-359-4129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-22
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3887152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEP807AMedicare PIN