MEDICARE: MACULA AND DIABETIC EYE CENTER LLC

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	174400000X	Specialist	ME102736	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AN586Z	OTHER		MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1922333186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MACULA AND DIABETIC EYE CENTER LLC

Provider Business Mailing Address
First Line	:	4916 26TH ST W
Second Line	:	STE 200
City	:	BRADENTON
State	:	FL
Zip	:	34207-1712
Country	:	US
Telephone Number	:	941-567-4078
Fax Number	:	941-896-7878

Provider Business Practice Location Address
First Line	:	4916 26TH ST W
Second Line	:	STE 200
City	:	BRADENTON
State	:	FL
Zip	:	34207-1712
Country	:	US
Telephone Number	:	941-567-4078
Fax Number	:	941-896-7878

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PETER G LIVINGSTON
Credential	:	M.D.
Telephone Number	:	941-539-6779

Provider Enumeration Date	:	10/06/2009
Last Update Date	:	03/24/2011

Similar Medicare Providers

1902172331 — SUNCOAST RETINA INSTITUTE, P.L.
Practice Location Address:

4916 26TH ST W , STE 200
BRADENTON, FL
34207-1712

Practice Phone: 941-567-4078
Practice Fax: 941-869-7878

1407298318 — MS. NANCY BAPTIST L.M.H.C. N.C.C.
Practice Location Address:

4916 26TH ST W , #100
BRADENTON, FL
34207-1712

Practice Phone: 941-556-1377
Practice Fax:

1477918324 — ANDREW BURKE
Practice Location Address:

4916 26TH ST W STE 104
BRADENTON, FL
34207-1712

Practice Phone: 941-870-7234
Practice Fax: 941-870-1012

1548077456 — ERIN R FORD ED.S., NCSP
Practice Location Address:

6410 ROSEHILL FARM RUN
BRADENTON, FL
34211-1712

Practice Phone: 901-730-6640
Practice Fax:

1609878594 — DR. GARRETT L HARTE DPM
Practice Location Address:

1800 CORTEZ RD W
BRADENTON, FL
34207-1335

Practice Phone: 941-758-8818
Practice Fax: 941-755-2901

1528060407 — DR. CHRISTOPHER J ADDISON DPM
Practice Location Address:

1800 CORTEZ RD W
BRADENTON, FL
34207-1335

Practice Phone: 941-758-8818
Practice Fax: 941-755-2901

Directions to “MACULA AND DIABETIC EYE CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.