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General NPI Number Information
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NPI Number | 1588801880
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Entity Type | Organization
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Legal Business Name | GEORGE L. VAZOULAS, O.D.,P.A.
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 07/17/2009
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Provider Practice Location Address
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Address Line | 3100 SW COLLEGE RD
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City | OCALA
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State | FL
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Zip | 34474-4419
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Country | US
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Telephone | 352-237-7001
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Fax |
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Provider Business Mailing Address
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Address Line | 3100 SW COLLEGE RD
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City | OCALA
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State | FL
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Zip | 34474-4419
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GEORGE VAZOULAS
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Credential |
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Telephone | 352-817-2625
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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 2634
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License Number State | FL
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