Retina and Macula Consultants PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

57634 Issued in FL

Legal business name

RETINA AND MACULA CONSULTANTS PA

Practice address

2400 S McCall Rd
Suite a
Englewood, FL 34224-5137

Phone

(941) 460-9159

Fax

(941) 460-9419

NPI assigned

Sep 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles M Gremillion Jr., M.D.NPI 1871572164

Title

President/Owner

Phone

(941) 460-9159

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Charles M Gremillion Jr., MD

  • Ophthalmology Physician
  • Englewood, FL
  • NPI 1871572164
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1922295641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S MCCALL RD",
            "address_2": "SUITE A",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342245137",
            "telephone_number": "941-460-9159",
            "fax_number": "941-460-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S MCCALL RD",
            "address_2": "SUITE A",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342245137",
            "telephone_number": "941-460-9159",
            "fax_number": "941-460-9419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA AND MACULA CONSULTANTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "GREMILLION",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "941-460-9159",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "57634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069437",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Redfish Cove Inpatient Services LLC
• Carol Ann Reed, LPTA
• Amanda Jayne Rees, ARNP; FNP-C
• Jessie Reese, L.M.T.
• Renewed Hope Healing Counseling Services, LLC
• Tina Marie Reynolds, NP
• Jeffrey Christopher Rice, DPT
• Selena Rice
• Richard L Llerena DO PA
• Jami Lynn Marie Rieffel, LMFT

• 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 Jul 30, 2008; 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.