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General NPI Number Information
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NPI Number | 1508301367
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN EYECARE OF FLORIDA
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Dates
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Enumeration Date | 01/03/2017
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Last Update Date | 01/03/2017
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Provider Practice Location Address
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Address Line | 5995 S POINTE BLVD STE 111
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City | FORT MYERS
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State | FL
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Zip | 33919-3273
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Country | US
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Telephone | 239-992-2020
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Fax | 239-992-2005
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Provider Business Mailing Address
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Address Line | 26381 S TAMIAMI TRL STE 112
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-7803
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Country | US
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Telephone | 239-992-2020
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Fax | 239-992-2005
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Authorized Official
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Title or Position | CHIEF OPTOMETRIC PHYSICIAN
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Name | DR. CHRISTINE BLISS DEE-REYES
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Credential | OD
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Telephone | 239-992-2020
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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 | OP0002994
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License Number State | FL
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