Provider Demographics
NPI:1669505293
Name:NAPLES EYECARE, INC.
Entity Type:Organization
Organization Name:NAPLES EYECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BRIENEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-597-1555
Mailing Address - Street 1:2464 VANDERBILT BEACH RD
Mailing Address - Street 2:SUITE 514
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2657
Mailing Address - Country:US
Mailing Address - Phone:239-597-1555
Mailing Address - Fax:
Practice Address - Street 1:2464 VANDERBILT BEACH RD
Practice Address - Street 2:SUITE 514
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2657
Practice Address - Country:US
Practice Address - Phone:239-597-1555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2980152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000K2302Medicare ID - Type UnspecifiedMEDICARE GROUP #