Provider Demographics
NPI:1942426283
Name:EYE PHYSICIANS OF CENTRAL FLORIDA
Entity Type:Organization
Organization Name:EYE PHYSICIANS OF CENTRAL FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERCHOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-767-6411
Mailing Address - Street 1:225 W STATE ROAD 434
Mailing Address - Street 2:STE 111
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4980
Mailing Address - Country:US
Mailing Address - Phone:407-767-6411
Mailing Address - Fax:407-767-8160
Practice Address - Street 1:225 W STATE ROAD 434
Practice Address - Street 2:STE 111
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4980
Practice Address - Country:US
Practice Address - Phone:407-767-6411
Practice Address - Fax:407-767-8160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0973100001Medicare PIN