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General NPI Number Information
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NPI Number | 1285180497
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Entity Type | Organization
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Legal Business Name | CORTEZ VISION CENTER LLC
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 6156 STATE ROAD 70 E
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City | BRADENTON
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State | FL
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Zip | 34203-9712
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Country | US
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Telephone | 941-753-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 6156 STATE ROAD 70 E
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City | BRADENTON
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State | FL
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Zip | 34203-9712
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Country | US
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Telephone | 941-753-2020
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANKIT PATEL
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Credential |
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Telephone | 727-642-4168
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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 | OPC 4909
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License Number State | FL
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