Healthcare Provider Details

I. General information

NPI: 1811186182
Provider Name (Legal Business Name): SKOS VISION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 10/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 BEE RIDGE RD
SARASOTA FL
34233-1207
US

IV. Provider business mailing address

3920 BEE RIDGE RD BUILDING A, SUITE A
SARASOTA FL
34233-1207
US

V. Phone/Fax

Practice location:
  • Phone: 941-923-3411
  • Fax:
Mailing address:
  • Phone: 941-923-3411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC4254
License Number StateFL

VIII. Authorized Official

Name: SUSAN BECK
Title or Position: OWNER
Credential: OD
Phone: 941-923-3411