Organization
QUAD CITIES RETINA CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONARDO M ANTARIS M.D. (OWNER)
(563) 326-8181
Entity
Organization
Contact information
Practice address
1230 E RUSHOLME ST, SUITE 107, DAVENPORT, IA 52803-2400
(563) 326-8181
(563) 326-8184
Mailing address
1230 E RUSHOLME ST, SUITE 107, DAVENPORT, IA 52803-2400
(563) 326-8181
(563) 326-8184
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
27394
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0293464
—
IA
01
—
29346
MEDICARE ID- TYPE UNSPECIFIED
IA
Enumeration date
07/31/2008
Last updated
06/21/2010
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