Amelia Eye Associates LLC
Organization Active NPI Corneal and Contact Management Optometrist · Fernandina Beach, FL
NPI 1376957571 · NPPES record last updated Sep 12, 2014
Key facts
- NPI
- 1376957571
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Corneal and Contact Management Optometrist 152WC0802X
- License
- OPC4033 (FL)
- Legal business name
- AMELIA EYE ASSOCIATES LLC
- Practice address
- 1411 S 14TH St
Suite G
Fernandina Beach, FL 32034-3031 - Phone
- (904) 321-1333
- Fax
- (904) 277-1255
- NPI assigned
- Jun 16, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Gerald William Koss II, O.D.
- Title
- Managing Member
- Phone
- (904) 321-1333
Practitioners 1
-
Gerald W. Koss II, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140924001398 | FL | Part B Supplier - Clinic/Group Practice | 9133348105 |
Receives reassigned benefits from 1 practitioner Practice locations: Fernandina Beach, FL |
National Provider Directory
Locations
1411 S 14th St
Ste G
Fernandina Beach, FL 32034
Phone (904) 321-1333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist |
152WC0802X | OPC4033 | FL | Yes |
Addresses
Primary practice location
1411 S 14TH St
Suite G
Fernandina Beach, FL 32034-3031
Mailing address
1411 S 14TH St
Suite G
Fernandina Beach, FL 32034-3031
Phone (904) 321-1333
Other providers in Fernandina Beach, FL
- Amelia Behavioral Wellness LLC
- Amelia Chiropractic Clinic
- Amelia Dental Group, PLLC
- Amelia Express Care, LLC
- Amelia Express Care, LLC
- Amelia Gentle Dentistry, LLC
- Amelia Institute of Cardiology and Medicine
- Amelia Internal Medicine,P.a.
- Amelia Island Anesthesia LLC
- Amelia Island Doctors of Optometry
All providers in Fernandina Beach, FL · Corneal and Contact Management Optometrist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.