Gresham, Travis A
Gresham, Travis A is an sole proprietor health care provider with primary practice located at 25225 Chamber Of Commerce Dr , Bonita Springs FL 34135-7887. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gresham, Travis A can be contacted via phone (239) 495-2020.Contact Information
Primary practice address
25225 Chamber Of Commerce Dr
Bonita Springs FL 34135-7887
Phone: (239) 495-2020
Fax: (239) 947-2020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | FL1224 | Florida |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC1224 | Florida |
Profile Details
| NPI number | 1861591349 |
|---|---|
| LBN Legal business name | Gresham, Travis A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 21st, 2006 |
| Last updated | Jul 4th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861591349 | NPPES |
| Florida | Other | 406580311 | R.R. MEDICARE |
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