NPIMap

Organization Active NPI

Eye Physicians and Surgeons of Florida PA

  • Optometrist
  • Fort Myers, FL
National Provider Identifier
1275648495
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ME41612 Issued in FL
Legal business name
EYE PHYSICIANS AND SURGEONS OF FLORIDA PA
Practice address
4790 Barkley Cir BLDG C-103
Fort Myers, FL 33907-7543
Phone
(239) 936-8686
Fax
(239) 936-2532
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John W Snead, MDNPI 1114911708
Title
President
Phone
(239) 936-8686

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X ME41612 FL Primary

Addresses

Primary practice location

4790 Barkley Cir BLDG C-103
Fort Myers, FL 33907-7543

Mailing address

4790 Barkley Cir BLDG C-103
Fort Myers, FL 33907-7543
Phone (239) 936-8686

Other identifiers 1

IdentifierTypeStateIssuer
250273900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100527000752 FL Part B Supplier - Clinic/Group Practice 7113056292 Receives reassigned benefits from 14 practitioners
Practice locations: Fort Myers, FL; Naples, FL; North Fort Myers, FL; Punta Gorda, FL

National Provider Directory

National Provider Directory
Tax ID family
Eye Physicians and Surgeons of Florida6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

28420 Bonita Crossings Blvd
Unit 120
Bonita Springs, FL 34135

28420 Bonita Crossings Blvd
Bonita Springs, FL 34135

1616 Cape Coral Pkwy W
Ste 113
Cape Coral, FL 33914

4790 Barkley Cir
#C101
Fort Myers, FL 33907
Phone (239) 277-1778

6435 Naples Blvd
Naples, FL 34109

5001 Taylor Rd
Punta Gorda, FL 33950
Phone (239) 766-4342

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1275648495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 BARKLEY CIR BLDG C-103",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077543",
            "telephone_number": "239-936-8686",
            "fax_number": "239-936-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4790 BARKLEY CIR BLDG C-103",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077543",
            "telephone_number": "239-936-8686",
            "fax_number": "239-936-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE PHYSICIANS AND SURGEONS OF FLORIDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "SNEAD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-936-8686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "ME41612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250273900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.