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Organization
BROOKS EYE CARE LLC
Active
Organization
BROOKS EYE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORDAN TROTTER BROOKS O.D. (PRESIDENT)
(239) 789-7899
Entity
Organization
Contact information
Practice address
8890 SALROSE LN, UNIT 203, FORT MYERS, FL 33912-2085
(239) 789-7899
Mailing address
8034 SILVER BIRCH WAY, LEHIGH ACRES, FL 33971-3769
(239) 789-7899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 4115
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36003
BLUECROSS BLUESHIELD
FL
05
—
621160700
—
FL
01
—
9213090
CIGNA
FL
Enumeration date
11/05/2013
Last updated
11/14/2014
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