Provider Demographics
NPI:1992855662
Name:EYE SPECIALIST OF FLORIDA P A
Entity type:Organization
Organization Name:EYE SPECIALIST OF FLORIDA P A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIZ-TOPPINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-243-8704
Mailing Address - Street 1:1804 OAKLEY SEAVER DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1925
Mailing Address - Country:US
Mailing Address - Phone:352-243-8704
Mailing Address - Fax:352-243-8705
Practice Address - Street 1:1804 OAKLEY SEAVER DR
Practice Address - Street 2:SUITE B
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1925
Practice Address - Country:US
Practice Address - Phone:352-243-8704
Practice Address - Fax:352-243-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1274680001Medicare NSC
FLK1033AMedicare PIN