Provider Demographics
NPI:1265464093
Name:VERNON A. STAPLETON, O.D.,P.A.
Entity Type:Organization
Organization Name:VERNON A. STAPLETON, O.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:STAPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:863-660-3287
Mailing Address - Street 1:PO BOX 91630
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33804-1630
Mailing Address - Country:US
Mailing Address - Phone:863-660-3287
Mailing Address - Fax:
Practice Address - Street 1:3800 NR 98
Practice Address - Street 2:#500
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809
Practice Address - Country:US
Practice Address - Phone:863-660-3287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty