Provider Demographics
NPI:1073649562
Name:STONYBROOK VENTURES INC
Entity Type:Organization
Organization Name:STONYBROOK VENTURES INC
Other - Org Name:PEARLE VISION OF LARGO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:CULLATHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-582-9070
Mailing Address - Street 1:10593 ULMERTON RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3529
Mailing Address - Country:US
Mailing Address - Phone:727-582-9070
Mailing Address - Fax:727-582-9189
Practice Address - Street 1:10593 ULMERTON RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3529
Practice Address - Country:US
Practice Address - Phone:727-582-9070
Practice Address - Fax:727-582-9189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service