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General NPI Number Information
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NPI Number | 1225290208
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Entity Type | Organization
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Legal Business Name | JOHN A. PETTIT, O.D.
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 3920 BEE RIDGE RD BLDG. A SUITE A
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City | SARASOTA
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State | FL
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Zip | 34233-1207
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Country | US
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Telephone | 941-923-3411
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Fax | 941-921-3832
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Provider Business Mailing Address
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Address Line | 3920 BEE RIDGE RD BLDG. A SUITE A
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City | SARASOTA
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State | FL
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Zip | 34233-1207
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Country | US
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Telephone | 941-923-3411
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Fax | 941-921-3832
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN A. PETTIT
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Credential | OD
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Telephone | 94192133411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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