| Johnson Eyecare, Llc | |
|
15661 San Carlos Blvd Fort Myers FL 33908-2797 | |
| (339) 221-4549 | |
| Not Available |
| Full Name | Johnson Eyecare, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15661 San Carlos Blvd, Fort Myers, Florida |
| Authorized Official Name and Position | Sarah Ann Johnson (OWNER) |
| Authorized Official Contact | 3392214549 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Johnson Eyecare, Llc 8584 Big Mangrove Dr Fort Myers FL 33908-7694 Ph: (339) 221-4549 | Johnson Eyecare, Llc 15661 San Carlos Blvd Fort Myers FL 33908-2797 Ph: (339) 221-4549 |
| NPI Number | 1275015133 |
|---|---|
| Provider Enumeration Date | 09/06/2018 |
| Last Update Date | 09/06/2018 |
| Medicare PECOS PAC ID | 6406193325 |
|---|---|
| Medicare Enrollment ID | O20190130000534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275015133 | NPI | - | NPPES |
| 720219 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | OPC4329 (ZZ) | Primary |
| Provider Name | Sarah A Johnson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1245496538 PECOS PAC ID: 3870651490 Enrollment ID: I20140919000947 |
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