Provider Demographics
NPI:1154008027
Name:ISLAND EYE SPECIALISTS, APC
Entity type:Organization
Organization Name:ISLAND EYE SPECIALISTS, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:AVALLONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-237-5531
Mailing Address - Street 1:671 B AVE
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-2225
Mailing Address - Country:US
Mailing Address - Phone:318-237-5531
Mailing Address - Fax:888-635-8108
Practice Address - Street 1:1317 YNEZ PL STE A
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-3909
Practice Address - Country:US
Practice Address - Phone:760-575-4541
Practice Address - Fax:888-635-8108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma SpecialistGroup - Multi-Specialty
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Multi-Specialty