MEDICARE: DAVID NESS OD PA

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	2612	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124295548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID NESS OD PA

Provider Business Mailing Address
First Line	:	15936 E HIGHWAY 40
Second Line	:
City	:	SILVER SPRINGS
State	:	FL
Zip	:	34488-5144
Country	:	US
Telephone Number	:	352-625-0135
Fax Number	:

Provider Business Practice Location Address
First Line	:	15936 E HIGHWAY 40
Second Line	:
City	:	SILVER SPRINGS
State	:	FL
Zip	:	34488-5144
Country	:	US
Telephone Number	:	352-625-0135
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID NESS
Credential	:	OD PA
Telephone Number	:	352-625-0135

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	05/14/2008

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Directions to “DAVID NESS OD PA ” Practice Location

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