Provider Demographics
NPI:1992398515
Name:EYE HEALTH CLINIC P.A.
Entity Type:Organization
Organization Name:EYE HEALTH CLINIC P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUZICKA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:850-739-2123
Mailing Address - Street 1:2120 APALACHEE PKWY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-4819
Mailing Address - Country:US
Mailing Address - Phone:850-273-7158
Mailing Address - Fax:
Practice Address - Street 1:2120 APALACHEE PKWY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-4819
Practice Address - Country:US
Practice Address - Phone:850-273-7158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty