Provider Demographics
NPI:1003006123
Name:INVISION EYECARE INC.
Entity Type:Organization
Organization Name:INVISION EYECARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:TUPPS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:727-734-8843
Mailing Address - Street 1:2161 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-5606
Mailing Address - Country:US
Mailing Address - Phone:727-734-8843
Mailing Address - Fax:727-733-4313
Practice Address - Street 1:2161 MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-5606
Practice Address - Country:US
Practice Address - Phone:727-734-8843
Practice Address - Fax:727-733-4313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2720152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL115712OtherEYEMED
FL20464OtherBCBS
FL1108130001Medicare NSC
FLU46999Medicare UPIN