NPIMap

Organization Active NPI

Fort Myers Eye Center Inc

  • Optometrist
  • Fort Myers, FL
National Provider Identifier
1740480870
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC0002377 Issued in FL
Legal business name
FORT MYERS EYE CENTER INC
Practice address
1537 Brantley Rd
Unit A2
Fort Myers, FL 33907-3923
Phone
(239) 481-7799
Fax
(239) 481-3739
NPI assigned
Jul 18, 2007
Last updated
Jun 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Dr. Bradley David Middaugh, O.D.NPI 1679575187
Title
President
Phone
(239) 481-7799

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC0002377 FL Primary

Addresses

Primary practice location

1537 Brantley Rd
Unit A2
Fort Myers, FL 33907-3923

Mailing address

1537 Brantley Rd
Unit A2
Fort Myers, FL 33907-3923
Phone (239) 481-7799

Other identifiers 2

IdentifierTypeStateIssuer
410041706OtherFLMEDICARE OTHER
078638100MedicaidFL

National Provider Directory

National Provider Directory

Locations

1537 Brantley Rd
#A2
Fort Myers, FL 33907
Phone (239) 481-7799

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1740480870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1537 BRANTLEY RD",
            "address_2": "UNIT A2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073923",
            "telephone_number": "239-481-7799",
            "fax_number": "239-481-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 BRANTLEY RD",
            "address_2": "UNIT A2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073923",
            "telephone_number": "239-481-7799",
            "fax_number": "239-481-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT MYERS EYE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "MIDDAUGH",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-481-7799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC0002377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OTHER",
            "identifier": "410041706",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078638100",
            "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 Jun 20, 2008; 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.