Optometrica O D P a

Optometrist · Sanibel, FL

Organization Active NPI

NPI number 1174879563

Practice location

1571 Periwinkle Way
Sanibel, FL 33957-4513
Phone
(239) 560-6917
Fax
(239) 415-7341

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NPI record

NPI
1174879563
Entity type
Organization (Type 2)
Enumeration date
August 3, 2012
Last updated
October 1, 2012
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Optometrist Primary 152W00000X OPC3502 FL

Mailing address

6747 Willow Lake Cir
Fort Myers, FL 33966-1253
Phone
(239) 560-6917
Fax
(239) 415-7341

Authorized official

Name
Dr. Phong Michael Pham, OD
Title
President / Owner
Phone
(239) 560-6917

About Optometrica O D P a

Optometrica O D P a is a healthcare organization registered in the NPI registry with the primary taxonomy Optometrist (code 152W00000X). The practice location is 1571 Periwinkle Way, Sanibel, FL 33957-4513. The NPI number 1174879563 was assigned on August 3, 2012 and the record was last updated on October 1, 2012.

Optometrica O D P a lists a license in the registry: #OPC3502 (FL) for Optometrist. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Dr. Phong Michael Pham, OD, President / Owner.

Frequently asked questions

What is the NPI number of Optometrica O D P a?

The NPI number is 1174879563.

What is the phone number of Optometrica O D P a?

The phone number listed for the practice location is (239) 560-6917.

Where is Optometrica O D P a located?

1571 Periwinkle Way, Sanibel, FL 33957-4513.

What is the taxonomy code for Optometrica O D P a?

The primary taxonomy code is 152W00000X – Optometrist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.