| Organization Name: | FLORIDA EYE CLINIC AMBULATORY SURGICAL CENTER, INC. |
| NPI Number: | 1073764106 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEN PARM (ADMINISTRATOR) |
| Mailing Address: | 975 Town Center Dr Suite 100 Orange City |
| State: | FL US |
| Postal Code: | 327638269 |
| Phone Number: | 4078347776 |
| Fax Number: | 4078340973 |
| NPI Enumeration Date: | 10/07/2008 |
| NPI Last Update Date: | 10/07/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 945 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |