Provider Demographics
NPI:1558980136
Name:EYE HEALTH OF FT MYERS LLC
Entity Type:Organization
Organization Name:EYE HEALTH OF FT MYERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:QUIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-466-2020
Mailing Address - Street 1:44 BARKLEY CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-7530
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20600 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954-2209
Practice Address - Country:US
Practice Address - Phone:941-766-7474
Practice Address - Fax:941-766-9111
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE HEALTH OF FT MYERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty