Provider Demographics
NPI:1003955071
Name:RICHARD A. CONROY,M.D.PA
Entity Type:Organization
Organization Name:RICHARD A. CONROY,M.D.PA
Other - Org Name:OASIS EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TRENITY
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-493-9393
Mailing Address - Street 1:1868 TAMIAMI TRL S
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-3160
Mailing Address - Country:US
Mailing Address - Phone:941-493-9393
Mailing Address - Fax:941-492-6650
Practice Address - Street 1:1868 TAMIAMI TRL S
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-3160
Practice Address - Country:US
Practice Address - Phone:941-493-9393
Practice Address - Fax:941-492-6650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME24018207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58511Medicare UPIN
FL78482XMedicare ID - Type Unspecified