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General NPI Number Information
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NPI Number | 1275638637
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Entity Type | Organization
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Legal Business Name | THE EYE DEPOT, P. A.
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 05/26/2021
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Provider Practice Location Address
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Address Line | 426 MANATEE AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-8845
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Country | US
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Telephone | 941-708-9000
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Fax | 941-746-7365
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Provider Business Mailing Address
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Address Line | 426 MANATEE AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-8845
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Country | US
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Telephone | 941-708-9000
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Fax | 941-746-7365
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM HOWARD MCSWAIN
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Credential | M.D.
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Telephone | 941-708-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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