Provider Demographics
NPI:1710161047
Name:MANATEE FAMILY EYECARE, PA
Entity Type:Organization
Organization Name:MANATEE FAMILY EYECARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAQUIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:941-792-7522
Mailing Address - Street 1:501 VILLAGE GREEN PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3401
Mailing Address - Country:US
Mailing Address - Phone:941-792-7522
Mailing Address - Fax:941-798-3713
Practice Address - Street 1:7423 MANATEE AVE W STE B
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-3403
Practice Address - Country:US
Practice Address - Phone:941-792-7522
Practice Address - Fax:941-798-3713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL39527BMedicare PIN