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General NPI Number Information
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NPI Number | 1023177953
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Entity Type | Organization
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Legal Business Name | NEODOC INC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2523 LEE BLVD
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City | LEHIGH ACRES
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State | FL
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Zip | 33971-1413
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Country | US
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Telephone | 239-368-0979
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Fax | 239-368-2591
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Provider Business Mailing Address
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Address Line | 1732 SUPREME CT
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City | NAPLES
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State | FL
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Zip | 34110
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Country | US
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Telephone | 239-285-6519
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Fax | 239-368-2591
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC MATTHEW CRITTENDEN
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Credential | OD
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Telephone | 239-285-6519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OP3105
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License Number State | FL
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