Provider Demographics
NPI:1447368725
Name:THE EYE ASSOCIATES OF MANATEE, LLP
Entity type:Organization
Organization Name:THE EYE ASSOCIATES OF MANATEE, LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER/MANAGING EM
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:941-792-2020
Mailing Address - Street 1:2203 61ST ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5528
Mailing Address - Country:US
Mailing Address - Phone:941-792-2020
Mailing Address - Fax:941-798-3995
Practice Address - Street 1:2111 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6104
Practice Address - Country:US
Practice Address - Phone:941-925-8888
Practice Address - Fax:941-924-8669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0544050006Medicare NSC