Provider Demographics
NPI:1275638637
Name:THE EYE DEPOT, P. A.
Entity Type:Organization
Organization Name:THE EYE DEPOT, P. A.
Other - Org Name:DANIEL B POPE MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:MCSWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-708-9000
Mailing Address - Street 1:426 MANATEE AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8845
Mailing Address - Country:US
Mailing Address - Phone:941-708-9000
Mailing Address - Fax:941-746-7365
Practice Address - Street 1:426 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8845
Practice Address - Country:US
Practice Address - Phone:941-708-9000
Practice Address - Fax:941-746-7365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265105000Medicaid