Healthcare Provider Details

I. General information

NPI: 1891573226
Provider Name (Legal Business Name): ADVANCED RETINA INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28901 TRAILS EDGE BLVD STE 202
BONITA SPRINGS FL
34134-7588
US

IV. Provider business mailing address

9431 CORKSCREW PALMS CIR
ESTERO FL
33928-6275
US

V. Phone/Fax

Practice location:
  • Phone: 239-544-3122
  • Fax: 239-544-3128
Mailing address:
  • Phone: 239-544-3122
  • Fax: 239-544-3128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL TSIPURSKY
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 847-323-5792