Provider Demographics
NPI:1609908300
Name:ACCUVISION OPTICAL OF TARPON SPRINGS INC.
Entity Type:Organization
Organization Name:ACCUVISION OPTICAL OF TARPON SPRINGS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-942-1289
Mailing Address - Street 1:40966 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-5446
Mailing Address - Country:US
Mailing Address - Phone:727-942-1289
Mailing Address - Fax:
Practice Address - Street 1:40966 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-5446
Practice Address - Country:US
Practice Address - Phone:727-942-1289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL003731332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier