MEDICARE: EYE ASSOCIATES OF MANATEE LLP

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	261QA1903X	Ambulatory Surgical Clinic/Center	752	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568460889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE ASSOCIATES OF MANATEE LLP

Provider Business Mailing Address
First Line	:	PO BOX 11407
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35246-8575
Country	:	US
Telephone Number	:	941-792-2020
Fax Number	:	941-782-1089

Provider Business Practice Location Address
First Line	:	6002 POINTE WEST BLVD
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-5531
Country	:	US
Telephone Number	:	941-792-2020
Fax Number	:	941-782-1089

Authorized Official
Title or Position	:	CFO
Name	:	KEVIN BECKER
Credential	:
Telephone Number	:	706-243-2259

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	07/22/2025

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