Provider Demographics
NPI:1790109361
Name:SOUTH FLORIDA EYE ASSOCIATES, PA
Entity Type:Organization
Organization Name:SOUTH FLORIDA EYE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P. PROFESSIONAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-461-0212
Mailing Address - Street 1:800 S DOUGLAS RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3125
Mailing Address - Country:US
Mailing Address - Phone:305-461-0212
Mailing Address - Fax:305-461-0208
Practice Address - Street 1:2900 W CYPRESS CREEK RD
Practice Address - Street 2:SUITE 1
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1715
Practice Address - Country:US
Practice Address - Phone:954-977-0192
Practice Address - Fax:954-977-0197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty