Edward Fetherolf M D P a

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME30596 Issued in FL

Legal business name

EDWARD FETHEROLF M D P A

Practice address

1500 Placida Rd
Suite B2
Englewood, FL 34223-4955

Phone

(941) 474-2266

Fax

(941) 475-7274

NPI assigned

Oct 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edward C Fetherolf, M.D.

Title

President

Phone

(941) 474-2266

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alan Knapp, MD

  • Ophthalmology Physician
  • Englewood, FL
  • NPI 1538277280

  Ophthalmology

  NPD (past)
• John Alan Sisti, O.D.

  • Optometrist
  • Warwick, RI
  • NPI 1679603096
  NPD (past)

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1730378282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 PLACIDA RD",
            "address_2": "SUITE B2",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234955",
            "telephone_number": "941-474-2266",
            "fax_number": "941-475-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PLACIDA RD",
            "address_2": "SUITE B2",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234955",
            "telephone_number": "941-474-2266",
            "fax_number": "941-475-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD FETHEROLF M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "FETHEROLF",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-474-2266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME30596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374759000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward George Dumas, LCSW
• Sharon Taylor Dunbar, LCSW
• Jessica Durand, PHARMACIST INTERN
• Megan M Earles, MSW, LCSW
• Carolyn Edlund, PA
• Ehra Medical Services of Florida LLC
• Andrew Cole Eisenberg, MD
• Ekiong C. Tan M.D., P.a.
• Elite Cardiology Care, LLC
• Elizabeth Cupo

• Ophthalmology Physician in Englewood, FL
• Providers in Englewood, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.