EYELID SURGERY CENTER, LLC (NPI# 1255325080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255325080 |
| Entity Type | Organization |
| Organization Name | EYELID SURGERY CENTER, LLC |
| Practice Address |
15620 New Hampshire Ct Fort Myers FL 33908-4168 |
| Practice Telephone | 2394819995 |
| Practice Fax Number | 2394819745 |
| Mailing Telephone | 2394819995 |
| Mailing Fax Number | 2394819745 |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ROBERT DUANE MARTILLA (ADMINISTRATOR) |
| Authorized Official Telephone | 2394819995 |
| Authorized Official Credential | RN, LHRM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
1220 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BC/BS FLORIDA | 6J5 | 01 |
| Street Address |
15620 NEW HAMPSHIRE CT |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33908-4168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588658306 | Bonnie Lou Kokal | Nurse Anesthetist, Certified Registered | 15620 New Hampshire Ct, Fort Myers, FL 33908-4168 | 2005-09-08 |
| 1205353687 | Gulfshore Dermatology, P.a. | Dermatology | 15620 New Hampshire Ct, Fort Myers, FL 33908-4168 | 2017-08-25 |
| 1083677926 | Jeffrey N Martin | Dermatology | 15620 New Hampshire Ct, Fort Myers, FL 33908-4168 | 2006-04-11 |
| 1679536510 | Mark C George | Physician Assistant | 15620 New Hampshire Ct, Fort Myers, FL 33908-4168 | 2006-04-11 |
| 1275527095 | Oculoplastics of Southwest Florida, Dean W. Larson, Md Pa | Ophthalmology | 15620 New Hampshire Ct, Fort Myers, FL 33908-4168 | 2005-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760081806 | 1 Recovery | Community/Behavioral Health | 111 Daniels Dr, Fort Myers, FL 33908 | 2020-10-20 |
| 1457916462 | Avipharm, LLC | Pharmacy | 7669 Calistoble Loop, 2nd Floor, Fort Myers, FL 33908 | 2019-05-06 |
| 1013492289 | Craig M Stein | Pharmacist | 15236 Tropic Bird Court, Fort Myers, FL 33908 | 2018-10-03 |
| 1730665167 | Kyndra Lynn Petrick | Psychiatry & Neurology | 8560 Big Mangrove Dr, Fort Myers, FL 33908 | 2018-07-18 |
| 1447757547 | Douglas L Jarrett | Nurse Practitioner | 16261 Bass Rd Suite 300, Fort Myers, FL 33908 | 2018-04-06 |
| 1447754825 | Luis Daniel Ramos | General Practice | 15590 Ocean Walk Cir Apt 201, Fort Myers, FL 33908 | 2018-03-21 |
| 1619497062 | Vanesa Paola Vaquer | Dentist | 18070 S Tamiami Trl Ste 101, Fort Myers, FL 33908 | 2017-06-26 |
| 1962859603 | Teresa Ruiz | Behavior Technician | 15081 Woodrich Bend Ct Apt 416, Fort Myers, FL 33908 | 2016-05-23 |
| 1669865721 | Elena B. Alexiev | Dentist | 18070 S. Tamiami Trail, #101, Fort Myers, FL 33908 | 2015-03-13 |
| 1134488919 | Cecelia Anne Collins | Dietitian, Registered | 9215 Calle Arragon Avenue, Unit 205, Fort Myers, FL 33908 | 2012-05-14 |
| Find all providers in zip 33908 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801458989 | Millennium Surgery Centers of Florida, LLC | Clinic/Center | 8380 Riverwalk Park Blvd Ste 220, Fort Myers, FL 33919-8758 | 2019-06-28 |
| 1861052896 | Premier Adult and Childrens Surgery Center LLC | Clinic/Center | 5238 Mason Corbin Ct Ste 101, Fort Myers, FL 33907-7738 | 2019-06-20 |
| 1134684814 | Performance Health Surgery Center | Clinic/Center | 9500 Gulf Research Lane, Fort Myers, FL 33912 | 2019-02-06 |
| 1972092146 | Surgery Centre of Sw Florida LLC | Clinic/Center | 13051 University Dr Ste 102, Fort Myers, FL 33907 | 2018-05-03 |
| 1265882096 | Prp Centers of Florida LLC | Clinic/Center | 1225 Sunbury Dr, Fort Myers, FL 33901-8738 | 2016-06-13 |
| 1992970230 | Park Center for Procedures LLC | Clinic/Center | 8255 College Parkway, Fort Myers, FL 33919-5193 | 2008-04-28 |
| 1609090257 | World Plaza Surgery LLC | Clinic/Center | 12640 World Plaza Ln # 71, Fort Myers, FL 33907-3987 | 2007-04-13 |
| 1225199482 | St Marks Surgical Center LLC | Clinic/Center | 6820 International Center Blvd, Fort Myers, FL 33912 | 2006-12-12 |
| 1457448912 | Gladiolus Surgery Center, LLC | Clinic/Center | 7431 Gladiolus Surgery Center, Fort Myers, FL 33908 | 2006-10-06 |
| 1053347203 | Dermatologic and Cosmetic Surgery | Clinic/Center | 2668 Swamp Cabbage Ct, Fort Myers, FL 33901-9332 | 2006-06-22 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33908 |
Please comment or provide details below to improve the information on EYELID SURGERY CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.