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General NPI Number Information
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NPI Number | 1609908300
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Entity Type | Organization
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Legal Business Name | ACCUVISION OPTICAL OF TARPON SPRINGS INC.
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 40966 US HIGHWAY 19 N
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-5446
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Country | US
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Telephone | 727-942-1289
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Fax |
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Provider Business Mailing Address
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Address Line | 40966 US HIGHWAY 19 N
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-5446
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Country | US
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Telephone | 727-942-1289
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Fax |
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Authorized Official
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Title or Position | OPTICIAN PRESIDENT
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Name | MRS. CATHY L CARSON
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Credential | D.O.
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Telephone | 727-942-1289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 003731
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License Number State | FL
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