Basic Information
| Provider Information | |||||||||
| NPI: | 1841226552 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NAPLES EYE SURGERY CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1890 SW HEALTH PKWY | ||||||||
| Address2: | #105 | ||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341090473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2395983653 | ||||||||
| FaxNumber: | 2395982712 | ||||||||
| Practice Location | |||||||||
| Address1: | 1890 SW HEALTH PKWY | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341090473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2395983653 | ||||||||
| FaxNumber: | 2399362532 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2006 | ||||||||
| LastUpdateDate: | 10/14/2013 | ||||||||
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| AuthorizedOfficialLastName: | SNEAD | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 2395982712 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | 1205 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.