OrganizationActive
Optometrica O D P a
NPI 1174879563 · Optometrist · Sanibel, FL
Provider details
- NPI number
- 1174879563
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Phong Pham, President / Owner(239) 560-6917
- License
- OPC3502 (FL)
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1571 Periwinkle Way
Sanibel, FL 33957-4513
Phone: (239) 560-6917
Fax: (239) 415-7341
Street-level locationGet directions
Mailing address
6747 Willow Lake Cir
Fort Myers, FL 33966-1253
Registry dates
- Enumerated
- 2012-08-03
- Last updated
- 2012-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.