Provider Demographics
NPI:1760696207
Name:CENTRAL FLORIDA EYE CARE LLC
Entity Type:Organization
Organization Name:CENTRAL FLORIDA EYE CARE LLC
Other - Org Name:JMS ENTERPRISES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:863-294-2332
Mailing Address - Street 1:813 KENILWORTH TER
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3902
Mailing Address - Country:US
Mailing Address - Phone:863-294-2332
Mailing Address - Fax:863-294-2334
Practice Address - Street 1:122 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-6308
Practice Address - Country:US
Practice Address - Phone:863-294-2332
Practice Address - Fax:863-294-2334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS-0006614207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDG7963OtherRAILROAD MEDICARE
FLAE598Medicare PIN