National Provider Identifier Database

GULF COAST RETINA ASSOCIATES LLC
Retina Specialist

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.


Contact Information

GULF COAST RETINA ASSOCIATES, LLC
2055 LITTLE RD
TRINITY, FL34655
Phone: 727-862-3090
Fax: 727-862-3023
Website:
Specialty Taxonomy Code
* Retina Specialist 207WX0107X

* Indicates primary specialty

NPI Profile & details for GULF COAST RETINA ASSOCIATES, LLC

NPI Number 1780724112
Legal business name
LBN
GULF COAST RETINA ASSOCIATES, LLC
Authorized official DOUG DAVIS - (OFFICE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 02/07/2007
Last updated 11/02/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: ME68907
  • FL Medicaid: 379522500

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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