Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edwin Detweiler III, OD

Individual provider Optometrist · NPI 1154303923

Edwin Detweiler III, OD is an Optometry in Bradenton, Florida. Graduated from Pennsylvania College of Optometry in 2005, 21 years ago. Practices with Madison Street Provider Network Inc, a 6-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
21
Trained at
Pennsylvania College of Optometry
Licensed in
FL
In the registry since
2005
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

6002 Pointe West Blvd
Bradenton, FL 34209-5531
Phone: (941) 792-2020
Fax: (941) 782-1089
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OPC4016 (FL)

Record details

NPI number1154303923
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedNovember 17, 2005
Last updated in NPPESMarch 12, 2019
Mailing address6002 Pointe West Blvd, Bradenton, FL 34209-5531

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolPENNSYLVANIA COLLEGE OF OPTOMETRY
Graduated 2005 (21 years in practice)
Group practice Madison Street Provider Network Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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