Organization
EDISON EYE CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN KONYNENBELT OD (MEMBER)
(616) 834-2598
Entity
Organization
Contact information
Practice address
19527 HIGHLAND OAKS DR STE 203, ESTERO, FL 33928-9637
(616) 834-2598
Mailing address
1214 SWEETWATER LN UNIT 2305, NAPLES, FL 34110-4177
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
—
—
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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