Provider Demographics
NPI:1861589343
Name:EYE SURGERY ASSOCIATES LLC
Entity type:Organization
Organization Name:EYE SURGERY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-214-0144
Mailing Address - Street 1:300 S PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8353
Mailing Address - Country:US
Mailing Address - Phone:954-925-2740
Mailing Address - Fax:954-927-1941
Practice Address - Street 1:300 S PARK RD STE 300
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8353
Practice Address - Country:US
Practice Address - Phone:954-925-2740
Practice Address - Fax:954-923-8379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0602931174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24555Medicare ID - Type UnspecifiedEYE SURGERY ASSOCIATES
FL0987090001Medicare NSC