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NPI Code Detail

MEDICARE: PRADO VISION LASIK CENTER LLC

MEDICARE: PRADO VISION LASIK CENTER LLC
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
1207W00000XOphthalmology PhysicianME64750FL

General Provider Information

NPI Number : 1568588705
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRADO VISION LASIK CENTER LLC
Provider Business Mailing Address
First Line : 7522 N HIMES AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-3205
Country : US
Telephone Number : 813-931-0500
Fax Number : 813-936-2805
Provider Business Practice Location Address
First Line : 7522 N HIMES AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-3205
Country : US
Telephone Number : 813-931-0500
Fax Number : 813-936-2805
Authorized Official
Title or Position : OWNER
Name : ANTONIO PRADO
Credential : M.D.
Telephone Number : 813-931-0500
Provider Enumeration Date : 03/21/2007
Last Update Date : 08/22/2020

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Directions to “PRADO VISION LASIK CENTER LLC ” Practice Location

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