Provider Demographics
NPI:1457817959
Name:EYE ASSOCIATES OF MANATEE, LLP
Entity Type:Organization
Organization Name:EYE ASSOCIATES OF MANATEE, LLP
Other - Org Name:ST. PETE THE EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-213-1385
Mailing Address - Street 1:1601 38TH AVENUE N.
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-1926
Mailing Address - Country:US
Mailing Address - Phone:727-822-4287
Mailing Address - Fax:727-822-1086
Practice Address - Street 1:1601 38TH AVENUE N.
Practice Address - Street 2:
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-1926
Practice Address - Country:US
Practice Address - Phone:727-822-4287
Practice Address - Fax:727-822-1086
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE ASSOCIATES OF MANATEE, LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier