Provider Demographics
NPI:1710394622
Name:FLORIDA RETINA SPECIALISTS, P.A.
Entity Type:Organization
Organization Name:FLORIDA RETINA SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:
Authorized Official - Last Name:VENZARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-735-8800
Mailing Address - Street 1:280 N SYKES CREEK PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3491
Mailing Address - Country:US
Mailing Address - Phone:321-735-8800
Mailing Address - Fax:321-735-8898
Practice Address - Street 1:280 N SYKES CREEK PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-3491
Practice Address - Country:US
Practice Address - Phone:321-735-8800
Practice Address - Fax:321-735-8898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty