Provider Demographics
NPI:1386312916
Name:ROCKMAN EYE ASSOCIATES PA
Entity type:Organization
Organization Name:ROCKMAN EYE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:786-285-5263
Mailing Address - Street 1:16073 RAVINA WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-3235
Mailing Address - Country:US
Mailing Address - Phone:786-285-5263
Mailing Address - Fax:
Practice Address - Street 1:2628 TAMIAMI TRL N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4409
Practice Address - Country:US
Practice Address - Phone:239-649-1650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013605300Medicaid