Provider Demographics
NPI:1962699538
Name:HARBORSIDE EYE SPECIALISTS, P.A.
Entity type:Organization
Organization Name:HARBORSIDE EYE SPECIALISTS, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLANO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:941-624-4500
Mailing Address - Street 1:PO BOX 495658
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-5658
Mailing Address - Country:US
Mailing Address - Phone:941-624-4500
Mailing Address - Fax:941-624-6066
Practice Address - Street 1:3430 TAMIAMI TRL
Practice Address - Street 2:SUITE A
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-8127
Practice Address - Country:US
Practice Address - Phone:941-624-4500
Practice Address - Fax:941-624-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CK4298OtherRR MEDICARE
CK4298OtherRR MEDICARE
1268470001Medicare NSC
FL002377500Medicaid