MEDICARE: VISION SPECIALTY ASSOCIATES, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013124643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION SPECIALTY ASSOCIATES, P.A.

Provider Business Mailing Address
First Line	:	4359 35TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33714-3717
Country	:	US
Telephone Number	:	727-914-8616
Fax Number	:	727-914-8610

Provider Business Practice Location Address
First Line	:	1661 SE US HIGHWAY 19
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-4830
Country	:	US
Telephone Number	:	352-563-1666
Fax Number	:	352-563-1673

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	ADAM J FURMAN
Credential	:	OD
Telephone Number	:	727-914-8616

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	09/06/2023

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