Provider Demographics
NPI:1033103999
Name:CAUSEY, MICHAEL J (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:CAUSEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9832 LITTLE ROAD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654
Mailing Address - Country:US
Mailing Address - Phone:727-868-9898
Mailing Address - Fax:727-862-4436
Practice Address - Street 1:9832 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-3470
Practice Address - Country:US
Practice Address - Phone:727-868-9898
Practice Address - Fax:727-862-4436
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2499152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6599521OtherGHI
FL7935776OtherCIGNA
FL078848100Medicaid
FL20328OtherBCBS
FL410019845OtherRR MEDICARE
FL208573OtherAVMED
FL20328ZMedicare PIN
FL208573OtherAVMED
FL20328OtherBCBS