Provider Demographics
NPI:1629188412
Name:NORMAN I MEYER MD PA
Entity Type:Organization
Organization Name:NORMAN I MEYER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:ISAAC
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-228-9900
Mailing Address - Street 1:13244 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3750
Mailing Address - Country:US
Mailing Address - Phone:772-228-9900
Mailing Address - Fax:772-228-9111
Practice Address - Street 1:13244 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3750
Practice Address - Country:US
Practice Address - Phone:772-228-9900
Practice Address - Fax:772-228-9111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME029272207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDD0933OtherRRB PTAN
FLK6133Medicare PIN
FLD50741Medicare UPIN