MEDICARE: EYE CENTERS 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

General Provider Information

NPI Number	:	1568014645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE CENTERS OF FLORIDA

Provider Business Mailing Address
First Line	:	4101 EVANS AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9310
Country	:	US
Telephone Number	:	239-939-3456
Fax Number	:	239-939-1575

Provider Business Practice Location Address
First Line	:	6891 DANIELS PKWY STE 140
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-1503
Country	:	US
Telephone Number	:	239-939-3456
Fax Number	:	239-936-8776

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	DAVID C BROWN
Credential	:
Telephone Number	:	239-939-3456

Provider Enumeration Date	:	07/10/2019
Last Update Date	:	07/10/2019

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Directions to “EYE CENTERS OF FLORIDA ” Practice Location

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