Organization
DERY & EADS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NORMAN JAMES DERY O.D. (OPTOMETRIST)
(239) 261-7071
Entity
Organization
Contact information
Practice address
60 10TH ST N, NAPLES, FL 34102-6217
(239) 261-7071
(239) 263-0807
Mailing address
60 10TH ST N, NAPLES, FL 34102-6217
(239) 261-7071
(239) 263-0807
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0978
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0482590001
DMERC-GROUP PTAN
FL
01
—
33184
GROUP MEDICARE NUMBER
FL
05
—
620721900
—
FL
Enumeration date
11/02/2006
Last updated
10/11/2011
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