Healthcare Provider Details

I. General information

NPI: 1578326385
Provider Name (Legal Business Name): CAMERON'S VISION, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 DEL PRADO BLVD S STE 202
CAPE CORAL FL
33990-3628
US

IV. Provider business mailing address

923 DEL PRADO BLVD S STE 202
CAPE CORAL FL
33990-3628
US

V. Phone/Fax

Practice location:
  • Phone: 352-234-0802
  • Fax:
Mailing address:
  • Phone: 352-234-0802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA CAMERON
Title or Position: PRESIDENT
Credential: OD FAAO
Phone: 352-234-0802