MEDICARE: JAMES A PODSCHUN 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	2303	FL

General Provider Information

NPI Number	:	1942518097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES A PODSCHUN OD PA

Provider Business Mailing Address
First Line	:	1935 STATE ROAD 436 STE 1001
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-2244
Country	:	US
Telephone Number	:	407-671-0960
Fax Number	:	407-677-6696

Provider Business Practice Location Address
First Line	:	1935 STATE ROAD 436 STE 1001
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-2244
Country	:	US
Telephone Number	:	407-671-0960
Fax Number	:	407-677-6696

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES PODSCHUN
Credential	:	O.D.
Telephone Number	:	407-671-0960

Provider Enumeration Date	:	09/22/2010
Last Update Date	:	02/05/2019

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