Provider Demographics
NPI:1952581753
Name:ORLANDO EYE ASSOCIATES
Entity Type:Organization
Organization Name:ORLANDO EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ONEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-351-3880
Mailing Address - Street 1:7682 DR PHILLIPS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-5152
Mailing Address - Country:US
Mailing Address - Phone:407-351-3880
Mailing Address - Fax:407-351-4648
Practice Address - Street 1:7682 DR PHILLIPS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5152
Practice Address - Country:US
Practice Address - Phone:407-351-3880
Practice Address - Fax:407-351-4648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1921152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3248Medicare PIN
FLT93946Medicare UPIN