MEDICARE: FORT MYERS EYE ASSOCIATES PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1386821122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FORT MYERS EYE ASSOCIATES PA

Provider Business Mailing Address
First Line	:	8801 COLLEGE PKWY STE 3
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-4882
Country	:	US
Telephone Number	:	239-437-2004
Fax Number	:	239-437-0501

Provider Business Practice Location Address
First Line	:	8801 COLLEGE PKWY STE 3
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-4882
Country	:	US
Telephone Number	:	239-437-2004
Fax Number	:	239-437-0501

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID F DALESIO
Credential	:	OD
Telephone Number	:	239-437-2004

Provider Enumeration Date	:	01/23/2008
Last Update Date	:	07/09/2010

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