Provider Demographics
NPI:1659097418
Name:EYE GUY ASSOCIATES OF FLORIDA LLC
Entity Type:Organization
Organization Name:EYE GUY ASSOCIATES OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TEGENKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:850-434-6387
Mailing Address - Street 1:5328 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2006
Mailing Address - Country:US
Mailing Address - Phone:850-434-6387
Mailing Address - Fax:850-432-0540
Practice Address - Street 1:5328 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2006
Practice Address - Country:US
Practice Address - Phone:850-434-6387
Practice Address - Fax:850-432-0540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty