Organization
OPTIEXPRESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JAMES WITHERINGTON OD (OPTOMETRIST/OWNER)
(239) 541-2020
Entity
Organization
Contact information
Practice address
513 CAPE CORAL PKWY W, CAPE CORAL, FL 33914-8507
(239) 541-2020
(239) 541-9300
Mailing address
513 CAPE CORAL PKWY W, CAPE CORAL, FL 33914-8507
(239) 541-2020
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
OPC1595
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19010
MEDICARE
FL
Enumeration date
08/20/2012
Last updated
08/20/2012
Update your record
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