Provider Demographics
NPI:1588656433
Name:OCALA EYE PA
Entity Type:Organization
Organization Name:OCALA EYE PA
Other - Org Name:OCALA EYE SURGEONS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDER
Authorized Official - Middle Name:N
Authorized Official - Last Name:SAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-622-5183
Mailing Address - Street 1:1500 SE MAGNOLIA EXT STE 101
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4452
Mailing Address - Country:US
Mailing Address - Phone:352-622-5183
Mailing Address - Fax:352-622-1348
Practice Address - Street 1:4414 SW COLLEGE RD STE 1462
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4790
Practice Address - Country:US
Practice Address - Phone:352-622-5183
Practice Address - Fax:352-629-5026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060140300Medicaid
FLCF7618OtherRAILROAD GROUP NUMBER
FL97806OtherBC/BS GROUP NUMBER
FLCF7618OtherRAILROAD GROUP NUMBER