MEDICARE: ASSOCIATES IN EYECARE OF FLORIDA

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	OP0002994	FL

General Provider Information

NPI Number	:	1508301367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATES IN EYECARE OF FLORIDA

Provider Business Mailing Address
First Line	:	26381 S TAMIAMI TRL STE 112
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7803
Country	:	US
Telephone Number	:	239-992-2020
Fax Number	:	239-992-2005

Provider Business Practice Location Address
First Line	:	5995 S POINTE BLVD STE 111
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3273
Country	:	US
Telephone Number	:	239-992-2020
Fax Number	:	239-992-2005

Authorized Official
Title or Position	:	CHIEF OPTOMETRIC PHYSICIAN
Name	:	DR. CHRISTINE BLISS DEE-REYES
Credential	:	OD
Telephone Number	:	239-992-2020

Provider Enumeration Date	:	01/03/2017
Last Update Date	:	01/03/2017

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