Healthcare Provider Details
I. General information
NPI: 1811960479
Provider Name (Legal Business Name): DIGAETANO CATARACT SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/13/2006
Last Update Date: 01/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
505 HEALTH BLVD
DAYTONA BEACH FL
32114-1493
US
IV. Provider business mailing address
505 HEALTH BLVD
DAYTONA BEACH FL
32114-1493
US
V. Phone/Fax
- Phone: 386-255-5050
- Fax: 386-255-5029
- Phone: 386-255-5050
- Fax: 386-255-5029
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MARGARET
DIGAETANO
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 386-255-5050