Provider Demographics
NPI:1053180877
Name:MANATEE EYE CARE, LLC
Entity type:Organization
Organization Name:MANATEE EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:REGO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-651-7228
Mailing Address - Street 1:6574 UNIVERSITY PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-9261
Mailing Address - Country:US
Mailing Address - Phone:941-278-5132
Mailing Address - Fax:
Practice Address - Street 1:6574 UNIVERSITY PKWY STE 110
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-9261
Practice Address - Country:US
Practice Address - Phone:941-278-5132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty