MEDICARE: NORMARK INC

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	156FX1800X	Optician	2348	FL

General Provider Information

NPI Number	:	1962431700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORMARK INC

Provider Business Mailing Address
First Line	:	4125 CLEVELAND AVE
Second Line	:	SUITE 1765
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9046
Country	:	US
Telephone Number	:	239-936-0332
Fax Number	:	239-936-1069

Provider Business Practice Location Address
First Line	:	4125 CLEVELAND AVE
Second Line	:	SUITE 1765
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9046
Country	:	US
Telephone Number	:	239-936-0332
Fax Number	:	239-936-1069

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. MARK SCHAFE
Credential	:	DO
Telephone Number	:	239-936-0332

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	01/21/2009

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Directions to “NORMARK INC ” Practice Location

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