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General NPI Number Information
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NPI Number | 1811186182
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Entity Type | Organization
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Legal Business Name | SKOS VISION CENTER INC
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 3920 BEE RIDGE RD
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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 |
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Provider Business Mailing Address
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Address Line | 3920 BEE RIDGE RD BUILDING 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 |
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN BECK
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Credential | OD
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Telephone | 941-923-3411
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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 | OPC4254
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License Number State | FL
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