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General NPI Number Information
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NPI Number | 1831286202
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Entity Type | Organization
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Legal Business Name | EYE CENTERS OF FLORIDA
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 08/05/2019
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Provider Practice Location Address
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Address Line | 4101 EVANS AVE
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City | FORT MYERS
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State | FL
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Zip | 33901-9310
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Country | US
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Telephone | 239-939-3456
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Fax | 239-790-2432
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Provider Business Mailing Address
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Address Line | 4101 EVANS AVE
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City | FORT MYERS
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State | FL
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Zip | 33901-9310
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Country | US
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Telephone | 239-939-3456
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Fax | 239-790-2432
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Authorized Official
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Title or Position | CEO PRESIDENT
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Name | DAVID C BROWN
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Credential |
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Telephone | 239-939-3456
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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 |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME11076
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License Number State | FL
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