Provider Demographics
NPI:1699879866
Name:EUGENIDES, JAMES (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:EUGENIDES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 PLACIDA RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-4912
Mailing Address - Country:US
Mailing Address - Phone:941-475-7991
Mailing Address - Fax:941-475-2066
Practice Address - Street 1:1800 PLACIDA RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-4912
Practice Address - Country:US
Practice Address - Phone:941-475-7991
Practice Address - Fax:941-475-2066
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2233152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19112OtherBLUE CROSS BLUE SHIELD
FL410035849OtherMEDICARE RAILROAD
FL19112OtherBLUE CROSS BLUE SHIELD
FLT95581Medicare UPIN
FL1699879866Medicare Oscar/Certification