Healthcare Provider Details

I. General information

NPI: 1043187602
Provider Name (Legal Business Name): VITALEYES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17809 SE 109TH AVE UNIT 2
SUMMERFIELD FL
34491-8912
US

IV. Provider business mailing address

2370 SE LAUREL RUN DR
OCALA FL
34471-8205
US

V. Phone/Fax

Practice location:
  • Phone: 352-804-2397
  • Fax: 352-244-8776
Mailing address:
  • Phone: 352-804-2397
  • Fax: 352-244-8776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALETHIA HELEN PANTAZIS
Title or Position: OWNER/PHYSICIAN
Credential:
Phone: 352-804-2397