Healthcare Provider Details

I. General information

NPI: 1285365049
Provider Name (Legal Business Name): EYE ASSOCIATES OF MANATEE LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 06/22/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3507 LEE BLVD STE 104
LEHIGH ACRES FL
33971-1303
US

IV. Provider business mailing address

PO BOX 162264
ALTAMONTE SPRINGS FL
32716-2264
US

V. Phone/Fax

Practice location:
  • Phone: 239-369-5884
  • Fax:
Mailing address:
  • Phone: 941-792-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: JOHN SWENCKI
Title or Position: CEO
Credential:
Phone: 941-379-0051