Provider Demographics
NPI:1922021195
Name:EATON, ALEXANDER M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:M
Last Name:EATON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1567 HAYLEY LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-2109
Mailing Address - Country:US
Mailing Address - Phone:239-337-3337
Mailing Address - Fax:239-936-2394
Practice Address - Street 1:1567 HAYLEY LN
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-2109
Practice Address - Country:US
Practice Address - Phone:239-337-3337
Practice Address - Fax:239-936-2394
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64350207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270531101Medicaid
FL23097Medicare PIN
E90831Medicare UPIN