Provider Demographics
NPI:1962431700
Name:NORMARK INC
Entity type:Organization
Organization Name:NORMARK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAFE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-936-0332
Mailing Address - Street 1:4125 CLEVELAND AVE
Mailing Address - Street 2:SUITE 1765
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9046
Mailing Address - Country:US
Mailing Address - Phone:239-936-0332
Mailing Address - Fax:239-936-1069
Practice Address - Street 1:4125 CLEVELAND AVE
Practice Address - Street 2:SUITE 1765
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9046
Practice Address - Country:US
Practice Address - Phone:239-936-0332
Practice Address - Fax:239-936-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2348156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0826760001Medicare NSC