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General NPI Number Information
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NPI Number | 1518457951
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Entity Type | Organization
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Legal Business Name | SEEWELL FAMILY VISION, LLC
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 612 S HUNT CLUB BLVD
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City | APOPKA
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State | FL
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Zip | 32703-4958
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Country | US
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Telephone | 321-279-6885
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Fax |
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Provider Business Mailing Address
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Address Line | 107 CAMDEN RD
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2644
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Country | US
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Telephone | 321-279-6885
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ROBERT PRADO
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Credential | OD
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Telephone | 321-279-6885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OPC2408
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License Number State | FL
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