Healthcare Provider Details
I. General information
NPI: 1225971237
Provider Name (Legal Business Name): BEYOND 2020 VISION SPECIALISTS BRADENTON
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4555 14TH ST W
BRADENTON FL
34207-1429
US
IV. Provider business mailing address
16230 STATE ROAD 54
ODESSA FL
33556-3729
US
V. Phone/Fax
- Phone: 941-755-0143
- Fax:
- Phone: 813-926-5993
- Fax: 813-926-5993
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
TUMOLO
Title or Position: DOCTOR
Credential: OD
Phone: 813-926-5993