MEDICARE: SOUTHWEST FLORIDA EYE CARE, L.L.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	ME66932	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770659856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST FLORIDA EYE CARE, L.L.C

Provider Business Mailing Address
First Line	:	6850 INTERNATIONAL CENTER BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-7129
Country	:	US
Telephone Number	:	239-768-0006
Fax Number	:	239-768-0850

Provider Business Practice Location Address
First Line	:	6850 INTERNATIONAL CNTR BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-7129
Country	:	US
Telephone Number	:	239-768-0006
Fax Number	:	239-768-0850

Authorized Official
Title or Position	:	CHIEF REVENUE CYCLE OFFICER
Name	:	LYNDA EVANS
Credential	:
Telephone Number	:	832-538-7999

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	05/27/2026

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