Healthcare Provider Details

I. General information

NPI: 1225292709
Provider Name (Legal Business Name): MARY ELIZABETH MCVEY OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 S MCCALL RD
ENGLEWOOD FL
34223-4958
US

IV. Provider business mailing address

1360 E VENICE AVE
VENICE FL
34285-9066
US

V. Phone/Fax

Practice location:
  • Phone: 941-474-2020
  • Fax: 941-473-4142
Mailing address:
  • Phone: 941-488-2020
  • Fax: 941-484-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5803
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License NumberOPC4593
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC4593
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number5803
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: