| Filutowski Eye Institute Pa | |
|
110 Yorktowne Drive Daytona Beach FL 32119 | |
| (386) 788-6696 | |
| (386) 788-2219 |
| Full Name | Filutowski Eye Institute Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 Yorktowne Drive, Daytona Beach, Florida |
| Authorized Official Name and Position | Konrad W Filutowski (PRESIDENT AND MEDICAL DIRECTOR) |
| Authorized Official Contact | 4073335111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Filutowski Eye Institute Pa 110 Yorktowne Dr Daytona Beach FL 32119-1471 Ph: (386) 788-6696 | Filutowski Eye Institute Pa 110 Yorktowne Drive Daytona Beach FL 32119 Ph: (386) 788-6696 |
| NPI Number | 1306910385 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 04/11/2017 |
| Medicare PECOS PAC ID | 6406843945 |
|---|---|
| Medicare Enrollment ID | O20080910000126 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306910385 | NPI | - | NPPES |
| 058564500 | Medicaid | FL | |
| 0082522 | Other | FL | GHI |
| 21305 | Other | FL | BCBSFL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Florida) | Primary |
| Provider Name | Wayne A Talsky |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730187311 PECOS PAC ID: 2769385657 Enrollment ID: I20040128001130 |
| Provider Name | Gayle Reed |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841399649 PECOS PAC ID: 1456242221 Enrollment ID: I20040322001234 |
| Provider Name | Angela K Dempsey |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1871715383 PECOS PAC ID: 9830186378 Enrollment ID: I20040427001602 |
| Provider Name | Jaime H Membreno |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1255309704 PECOS PAC ID: 2163400466 Enrollment ID: I20040713000326 |
| Provider Name | Rima K Klimas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992876197 PECOS PAC ID: 4880647049 Enrollment ID: I20050228000675 |
| Provider Name | Robert M Grossmann |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306917554 PECOS PAC ID: 6204881246 Enrollment ID: I20050314000175 |
| Provider Name | Shane B Keast |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871636621 PECOS PAC ID: 8820019565 Enrollment ID: I20051210000026 |
| Provider Name | Bonnie B Tretter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922031236 PECOS PAC ID: 6103908660 Enrollment ID: I20080123000688 |
| Provider Name | Konrad W Filutowski |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1134295744 PECOS PAC ID: 9032106570 Enrollment ID: I20080512000276 |
| Provider Name | Kara Meg Bachus |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174694376 PECOS PAC ID: 1254401078 Enrollment ID: I20080605000698 |
| Provider Name | Jessica Dorsey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821258856 PECOS PAC ID: 5698840106 Enrollment ID: I20080819000193 |
| Provider Name | Randall J Wilke |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457547416 PECOS PAC ID: 8022106681 Enrollment ID: I20080915000539 |
| Provider Name | Nader Moinfar |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1740206028 PECOS PAC ID: 3375671233 Enrollment ID: I20100513000531 |
| Provider Name | Valerie Best |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164771432 PECOS PAC ID: 8628213576 Enrollment ID: I20130325000034 |
| Provider Name | Rosalind I Torres |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912247347 PECOS PAC ID: 7416198981 Enrollment ID: I20130725000397 |
| Provider Name | Tanis L Burgess Baker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386083574 PECOS PAC ID: 3274775069 Enrollment ID: I20130807000244 |
| Provider Name | Danielle Drtina Williams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376924563 PECOS PAC ID: 3476868647 Enrollment ID: I20150817002410 |
| Provider Name | Tosha R Dorazio |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992285407 PECOS PAC ID: 2567716178 Enrollment ID: I20181119001237 |
| Provider Name | Gustavo Costa Munguba |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1093101834 PECOS PAC ID: 4981035326 Enrollment ID: I20200519000940 |
| Provider Name | Eduardo A Bustamante |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1154711513 PECOS PAC ID: 4183910664 Enrollment ID: I20200629002145 |
| Provider Name | Siripong Rojanasthien |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1457706723 PECOS PAC ID: 4284918525 Enrollment ID: I20200723003788 |
| Provider Name | London England-lewis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376831099 PECOS PAC ID: 0547432205 Enrollment ID: I20200930001773 |
| Provider Name | Alyssa L Perlman-hensen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154842961 PECOS PAC ID: 6901163757 Enrollment ID: I20210526001764 |
| Provider Name | Ariana C Diamond |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1871029470 PECOS PAC ID: 0244589331 Enrollment ID: I20210716001464 |
| Provider Name | Adel Bashirimoghaddam |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518537612 PECOS PAC ID: 2062806565 Enrollment ID: I20220228000220 |
| Provider Name | Oliver Filutowski |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1750842092 PECOS PAC ID: 5890153738 Enrollment ID: I20230624000012 |
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