Organization
FORT MYERS EYE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY DAVID MIDDAUGH O.D. (PRESIDENT)
(239) 481-7799
Entity
Organization
Contact information
Practice address
1537 BRANTLEY RD, UNIT A2, FORT MYERS, FL 33907-3923
(239) 481-7799
(239) 481-3739
Mailing address
1537 BRANTLEY RD, UNIT A2, FORT MYERS, FL 33907-3923
(239) 481-7799
(239) 481-3739
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC0002377
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078638100
—
FL
01
—
410041706
MEDICARE OTHER
FL
Enumeration date
07/18/2007
Last updated
06/20/2008
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