Provider Demographics
NPI:1972195253
Name:CITRUS PARK EYE CENTER INC
Entity Type:Organization
Organization Name:CITRUS PARK EYE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:813-230-9406
Mailing Address - Street 1:14018 WOLCOTT DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2551
Mailing Address - Country:US
Mailing Address - Phone:813-230-9406
Mailing Address - Fax:
Practice Address - Street 1:7865 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1611
Practice Address - Country:US
Practice Address - Phone:813-792-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty