1861446098 NPI number — APPLE OPHTHALMIC PA

Table of content: (NPI 1861446098)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861446098 NPI number — APPLE OPHTHALMIC PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APPLE OPHTHALMIC PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861446098
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 MEDICAL BLVD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
SPRING HILL
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34609-0220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-666-9990
Provider Business Mailing Address Fax Number:
352-666-1905

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 MEDICAL BLVD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SPRING HILL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34609-0220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-666-9990
Provider Business Practice Location Address Fax Number:
352-666-1905
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STOLTE
Authorized Official First Name:
KEITH
Authorized Official Middle Name:
B
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
352-666-9990

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  ME0043218 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com