Provider Demographics
NPI:1558373464
Name:NYE, PHILLIP A (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:A
Last Name:NYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 37TH ST STE 111
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6518
Mailing Address - Country:US
Mailing Address - Phone:772-226-6855
Mailing Address - Fax:
Practice Address - Street 1:1485 37TH ST STE 111
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6518
Practice Address - Country:US
Practice Address - Phone:772-226-6855
Practice Address - Fax:772-226-6854
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95624207L00000X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F1422OtherADVANCED EYE SURGERY CENTER
1649353582OtherADVANCED EYE SURGERY CENTER
FLME95624OtherSLEEP MEDICINE