Provider Demographics
NPI:1841226552
Name:NAPLES EYE SURGERY CENTER LLC
Entity type:Organization
Organization Name:NAPLES EYE SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:SNEAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-598-2712
Mailing Address - Street 1:1890 SW HEALTH PKWY
Mailing Address - Street 2:#105
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0473
Mailing Address - Country:US
Mailing Address - Phone:239-598-3653
Mailing Address - Fax:239-598-2712
Practice Address - Street 1:1890 SW HEALTH PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0473
Practice Address - Country:US
Practice Address - Phone:239-598-3653
Practice Address - Fax:239-936-2532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1205261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF1425Medicare PIN