Organization
RICHARD M DAVIS MD PA
Active
Parent organization
RICHARD M DAVIS MD PA
Other names
Cypress Lake Eyewear
Organization subpart
Yes
Provider details
NPI number
Legal business name
RICHARD M DAVIS MD PA
Authorized official
MR. RICHARD M DAVIS MD (PRESIDENT)
(239) 481-3343
Entity
Organization
Contact information
Practice address
9201 CYPRESS LAKE DR, FORT MYERS, FL 33919-4941
(239) 481-8171
(239) 482-5227
Mailing address
9201 CYPRESS LAKE DR, FORT MYERS, FL 33919-4941
(239) 481-8171
(239) 482-5227
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
0000176
FL
332H00000X
Eyewear Supplier
000176
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0499890001
D MERC
—
01
—
18778423210
UNITED HEALTHCARE
—
01
—
6924
AVESIS
—
Enumeration date
11/03/2005
Last updated
06/25/2008
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