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NPI Code Detail

MEDICARE: MICHAEL DAVID WESSON O.D.

MEDICARE: MICHAEL DAVID WESSON O.D.
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
1152W00000XOptometristR117-TA-093AL
2152W00000XOptometristOPC0843FL
3152W00000XOptometristOPT002219GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120767AOTHERFLMEDICARE ID - TYPE UNSPECIFIED

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
320767OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1285695916
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL DAVID WESSON O.D.
Provider Business Mailing Address
First Line : 5001 TAYLOR ROAD
Second Line :
City : PUNTA GORDA
State : FL
Zip : 33950-4722
Country : US
Telephone Number : 941-575-0903
Fax Number : 941-575-0905
Provider Business Practice Location Address
First Line : 5001 TAYLOR ROAD
Second Line :
City : PUNTA GORDA
State : FL
Zip : 33950-4722
Country : US
Telephone Number : 941-575-0903
Fax Number : 941-575-0905
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2006
Last Update Date : 04/22/2022

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