Provider Demographics
NPI:1003344359
Name:FERLITA, VINCENT MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:MICHAEL
Last Name:FERLITA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5404 MONTICELLO HALL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-5670
Mailing Address - Country:US
Mailing Address - Phone:352-279-8218
Mailing Address - Fax:
Practice Address - Street 1:24200 US HIGHWAY 23 S
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-9002
Practice Address - Country:US
Practice Address - Phone:740-477-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6547152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist