VITREO RETINAL SURGEONS LLC NPI 1194714485

NPI Information

  • NPI: 1194714485
  • Provider Name: VITREO RETINAL SURGEONS LLC
  • Classification: Ophthalmology - 207W00000X
  • Entity Type: Organization
  • Address: 11373 CORTEZ BLVD
    STE 400
    BROOKSVILLE, FL
    ZIP 34613
  • Phone: (352) 597-2604

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NPI Details

VITREO RETINAL SURGEONS LLC is an ophthalmology in Brooksville, FL. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. VITREO RETINAL SURGEONS LLC NPI is 1194714485. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11373 CORTEZ BLVD
STE 400
BROOKSVILLE, FL
ZIP 34613-414
Phone: (352) 597-2604
Fax: (352) 596-0520

The provider's authorized official is Thomas G Ward .
The authorized official title is Physician Surgeon Owner and has the following contact phone number (352) 597-2604.

The enumeration date for this NPI number is 10/19/2005 and was last updated on 9/15/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207W00000XOphthalmologyOS04712FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1371161700MEDICAIDFLORIDA
2E61795MEDICARE UPIN
339124AMEDICARE ID-TYPE UNSPECIFIEDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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