Healthcare Provider Details

I. General information

NPI: 1063324937
Provider Name (Legal Business Name): BEYOND 2020 VISION SPECIALISTS FOWLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2798 E FOWLER AVE STE 940
TAMPA FL
33612-6207
US

IV. Provider business mailing address

4974 RIDGEMOOR BLVD
PALM HARBOR FL
34685-1744
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-5728
  • Fax: 813-972-7544
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER TUMOLO
Title or Position: OWNER
Credential: OD
Phone: 727-242-8388