Provider Demographics
NPI:1003561283
Name:BEYOND 2020 VISION SPECIALISTS LLC
Entity Type:Organization
Organization Name:BEYOND 2020 VISION SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:TUMOLO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:727-657-8830
Mailing Address - Street 1:5041 PALOMA DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-4343
Mailing Address - Country:US
Mailing Address - Phone:727-657-8830
Mailing Address - Fax:
Practice Address - Street 1:16230 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-3729
Practice Address - Country:US
Practice Address - Phone:813-926-5993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty