1851847826 NPI number — EYE PHYSICIANS AND SURGEONS OF FLORIDA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851847826 NPI number — EYE PHYSICIANS AND SURGEONS OF FLORIDA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EYE PHYSICIANS AND SURGEONS OF FLORIDA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851847826
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4790 BARKLEY CIR STE C103
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT MYERS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33907-7593
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-936-8686
Provider Business Mailing Address Fax Number:
239-936-2532

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15205 COLLIER BLVD # 101102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34119-6769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-348-7145
Provider Business Practice Location Address Fax Number:
239-348-7619
Provider Enumeration Date:
08/30/2016

Additional Information

Authorized Official

Authorized Official Last Name:
CHESTER-HAMM
Authorized Official First Name:
CECILIA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
239-936-8686

Provider Taxonomy Codes

  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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