Healthcare Provider Details

I. General information

NPI: 1982861175
Provider Name (Legal Business Name): EYE PHYSICIANS AND SURGEONS OF FLORIDA PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4790 BARKLEY CIR BLDG C-103
FORT MYERS FL
33907-7543
US

IV. Provider business mailing address

4790 BARKLEY CIR BLDG C-103
FORT MYERS FL
33907-7543
US

V. Phone/Fax

Practice location:
  • Phone: 239-936-8686
  • Fax: 239-936-2532
Mailing address:
  • Phone: 239-936-8686
  • Fax: 239-936-2532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN W SNEAD
Title or Position: PRESIDENT
Credential: MD
Phone: 239-936-8686