Provider Demographics
NPI:1275129983
Name:STELLAR VISION LLC
Entity Type:Organization
Organization Name:STELLAR VISION LLC
Other - Org Name:STELLA VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGONA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:239-841-2551
Mailing Address - Street 1:42041 CYPRESS PKWY UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33982-5140
Mailing Address - Country:US
Mailing Address - Phone:239-731-0060
Mailing Address - Fax:239-731-1286
Practice Address - Street 1:42041 CYPRESS PKWY UNIT 3
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33982-5140
Practice Address - Country:US
Practice Address - Phone:239-731-0060
Practice Address - Fax:239-731-1286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty