# RETINA AND MACULA CONSULTANTS PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922295641
- **Authorized official:** DR. CHARLES M GREMILLION JR. M.D. (PRESIDENT/OWNER)
- **Authorized official phone:** (941) 460-9159

## Contact information

- **Practice address:** 2400 S MCCALL RD, SUITE A, ENGLEWOOD, FL 34224-5137
- **Practice address phone:** (941) 460-9159
- **Practice address fax:** (941) 460-9419
- **Mailing address:** 2400 S MCCALL RD, SUITE A, ENGLEWOOD, FL 34224-5137
- **Mailing address phone:** (941) 460-9159
- **Mailing address fax:** (941) 460-9419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 57634 | FL | Yes |

## Other

- **Enumeration date:** 09/26/2007
- **Last updated:** 07/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 069437 | — | FL |