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Organization
FORT MYERS EYE CENTER INC
Active
Organization
FORT MYERS EYE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY DAVID MIDDAUGH O.D. (PRESIDENT)
(239) 481-7799
Entity
Organization
Contact information
Practice address
1537 BRANTLEY RD, UNIT A2, FORT MYERS, FL 33907-3923
(239) 481-7799
(239) 481-3739
Mailing address
1537 BRANTLEY RD, UNIT A2, FORT MYERS, FL 33907-3923
(239) 481-7799
(239) 481-3739
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC0002377
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078638100
—
FL
01
—
410041706
MEDICARE OTHER
FL
Enumeration date
07/18/2007
Last updated
06/20/2008
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