Provider Demographics
NPI:1053356337
Name:FLORIDA EYE INSTITUTE, P.A.
Entity type:Organization
Organization Name:FLORIDA EYE INSTITUTE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:VAL
Authorized Official - Last Name:ZUDANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-569-9500
Mailing Address - Street 1:2750 INDIAN RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960
Mailing Address - Country:US
Mailing Address - Phone:772-569-9500
Mailing Address - Fax:772-569-9507
Practice Address - Street 1:2750 INDIAN RIVER BLVD
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960
Practice Address - Country:US
Practice Address - Phone:772-569-9500
Practice Address - Fax:772-569-9507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCA6346OtherRR MEDICARE
FL253823700Medicaid
FL97672Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO.
FLCA6346OtherRR MEDICARE