Doctors Eyecare Center of SW Florida, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC001100 Issued in FL

Legal business name

DOCTORS EYECARE CENTER OF SW FLORIDA, LLC

Doing business as

Doctors Eyecare Centers

Practice address

5995 S Pointe Blvd
Ste 111
Fort Myers, FL 33919-3273

Phone

(239) 482-0355

Fax

(239) 482-8930

NPI assigned

Nov 16, 2006

Last updated

Jun 7, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy E. Underhill, O.D.NPI 1629074067

Title

Owner/Manager

Phone

(239) 482-0355

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Doctors Eyecare Centers Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 4

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.

• Timothy E. Underhill, O.D.

  • Optometrist
  • Fort Myers, FL
  • NPI 1629074067
  Medicare reassignment NPD Authorized official
• Thomas Alan Underhill, O.D.

  • Optometrist
  • Fort Myers, FL
  • NPI 1477079598
  Medicare reassignment NPD
• Charles Daren Fitzpatrick, D.C.

  • Chiropractor
  • Fort Myers, FL
  • NPI 1417986845
  NPD (past)
• Vidya P Kini, MD

  • Physical Medicine & Rehabilitation Physician
  • Fort Myers, FL
  • NPI 1538154547
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1669545737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 S POINTE BLVD",
            "address_2": "STE 111",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193273",
            "telephone_number": "239-482-0355",
            "fax_number": "239-482-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 S POINTE BLVD",
            "address_2": "STE 111",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193273",
            "telephone_number": "239-482-0355",
            "fax_number": "239-482-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS EYECARE CENTER OF SW FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "UNDERHILL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "239-482-0355",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC001100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078232700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620835500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Eyecare Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.