Healthcare Provider Details

I. General information

NPI: 1003302712
Provider Name (Legal Business Name): OCUFLOW DOPPLER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 VETERANS PARK DR STE 302
NAPLES FL
34109-0446
US

IV. Provider business mailing address

1855 VETERANS PARK DR STE 302
NAPLES FL
34109-0446
US

V. Phone/Fax

Practice location:
  • Phone: 239-324-4888
  • Fax: 877-717-0096
Mailing address:
  • Phone: 239-324-4888
  • Fax: 877-717-0096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME97301
License Number StateFL

VIII. Authorized Official

Name: JAMES BRANCH
Title or Position: BILLING MANAGER
Credential:
Phone: 239-324-4888