Provider Demographics
NPI:1154700466
Name:ESTERO EYECARE
Entity type:Organization
Organization Name:ESTERO EYECARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GEARING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:239-898-8712
Mailing Address - Street 1:8040 MEDITERRANEAN DR
Mailing Address - Street 2:INSIDE TARGET OPTICAL
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-8304
Mailing Address - Country:US
Mailing Address - Phone:239-390-2945
Mailing Address - Fax:239-390-3195
Practice Address - Street 1:21753 BRIXHAM RUN LOOP
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928
Practice Address - Country:US
Practice Address - Phone:239-898-8712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3648261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care