Organization
RETINA AND MACULA CONSULTANTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES M GREMILLION JR. M.D. (PRESIDENT/OWNER)
(941) 460-9159
Entity
Organization
Contact information
Practice address
2400 S MCCALL RD, SUITE A, ENGLEWOOD, FL 34224-5137
(941) 460-9159
(941) 460-9419
Mailing address
2400 S MCCALL RD, SUITE A, ENGLEWOOD, FL 34224-5137
(941) 460-9159
(941) 460-9419
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
57634
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
069437
—
FL
Enumeration date
09/26/2007
Last updated
07/30/2008
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