Provider Demographics
NPI:1366474058
Name:BOVIO, STEVEN (OD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:BOVIO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3691 WEBBER ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-4412
Mailing Address - Country:US
Mailing Address - Phone:941-921-2020
Mailing Address - Fax:941-922-1333
Practice Address - Street 1:2940 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5105
Practice Address - Country:US
Practice Address - Phone:941-921-2020
Practice Address - Fax:941-922-1333
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2979152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20695OtherBLUE CROSS BLUE SHIELD
FL2311408OtherAETNA HMO
FL7539256OtherAETNA PPO
FL20695AMedicare PIN
FL20695OtherBLUE CROSS BLUE SHIELD
FL7539256OtherAETNA PPO