Provider Demographics
NPI:1639336324
Name:CAMPBELL, RON
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:RON
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:4455 HARBOUR LIGHTS CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1208
Mailing Address - Country:US
Mailing Address - Phone:407-493-3240
Mailing Address - Fax:
Practice Address - Street 1:1415 STATE ROAD 436
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707
Practice Address - Country:US
Practice Address - Phone:407-831-6545
Practice Address - Fax:407-831-6086
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2441152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist