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General NPI Number Information
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NPI Number | 1700073699
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Entity Type | Organization
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Legal Business Name | NAPLES EYE PHYSICIANS OPTICAL SHOP, INC
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 05/03/2013
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Provider Practice Location Address
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Address Line | 661 GOODLETTE RD N SUITE 105
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City | NAPLES
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State | FL
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Zip | 34102-5609
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Country | US
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Telephone | 239-435-0645
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Fax | 239-262-5434
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Provider Business Mailing Address
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Address Line | 661 GOODLETTE RD N SUITE 105
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City | NAPLES
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State | FL
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Zip | 34102-5609
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Country | US
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Telephone | 239-435-0645
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Fax | 239-262-5434
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. PAUL M ROUGRAFF
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Credential | M.D.
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Telephone | 239-262-6288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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