Provider Demographics
NPI:1922632066
Name:ST CLOUD EYE CENTER INC
Entity Type:Organization
Organization Name:ST CLOUD EYE CENTER INC
Other - Org Name:EYE FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LY
Authorized Official - Middle Name:THI
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-891-2010
Mailing Address - Street 1:4589 H C YATES LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-6764
Mailing Address - Country:US
Mailing Address - Phone:407-891-2010
Mailing Address - Fax:407-891-8211
Practice Address - Street 1:1330 BUDINGER AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4137
Practice Address - Country:US
Practice Address - Phone:407-891-2010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST CLOUD EYE CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-27
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty