Provider Demographics
NPI:1659371714
Name:CENTRAL FLORIDA EYE INSTITUTE PL
Entity Type:Organization
Organization Name:CENTRAL FLORIDA EYE INSTITUTE PL
Other - Org Name:OPTICAL SHOP
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:CROLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-237-8400
Mailing Address - Street 1:3133 SW 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-4446
Mailing Address - Country:US
Mailing Address - Phone:352-237-8400
Mailing Address - Fax:352-237-7190
Practice Address - Street 1:3133 SW 32ND AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-4446
Practice Address - Country:US
Practice Address - Phone:352-237-8400
Practice Address - Fax:352-237-7190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0048124332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5183990001OtherRR MEDICARE ID
FL5183990001Medicare ID - Type Unspecified