Basic Information
| Provider Information | |||||||||
| NPI: | 1124334768 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EYE PHYSICIANS AND SURGEONS OF FLORIDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4790 BARKLEY CIR BLDG C-103 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339077543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2399368686 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5335 AIRPORT PULLING RD N | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341092011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2395945550 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2010 | ||||||||
| LastUpdateDate: | 12/09/2016 | ||||||||
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| AuthorizedOfficialLastName: | SNEAD | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2399368686 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332H00000X | ME41612 | FL | Y | Suppliers | Eyewear Supplier (Equipment, not the service) |
No ID Information.