Basic Information
| Provider Information | |||||||||
| NPI: | 1487980967 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EYE SPECIALISTS OF MID FLORIDA, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5032 US HIGHWAY 27 N | ||||||||
| Address2: | |||||||||
| City: | SEBRING | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338701354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8633823900 | ||||||||
| FaxNumber: | 8633857442 | ||||||||
| Practice Location | |||||||||
| Address1: | 5032 US HIGHWAY 27 N | ||||||||
| Address2: | |||||||||
| City: | SEBRING | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338701354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8633823900 | ||||||||
| FaxNumber: | 8633857442 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2009 | ||||||||
| LastUpdateDate: | 02/27/2013 | ||||||||
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| AuthorizedOfficialLastName: | WELCH | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8632943504 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | EYE SPECIAISTS OF MID FLORIDA, P.A. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | ME32357 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.