Healthcare Provider Details

I. General information

NPI: 1730978073
Provider Name (Legal Business Name): BRUNSWICK HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2025
Last Update Date: 05/03/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 TARPON BAY BLVD
NAPLES FL
34119-8764
US

IV. Provider business mailing address

27028 BELLE RIO DR
BONITA SPRINGS FL
34135-4427
US

V. Phone/Fax

Practice location:
  • Phone: 239-206-1192
  • Fax: 813-807-5256
Mailing address:
  • Phone: 239-206-1192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DANIEL HACHEY
Title or Position: MANAGING MEMBER
Credential: OD
Phone: 239-206-1192