Provider Demographics
NPI:1689881237
Name:VISION SPECIALTY ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:VISION SPECIALTY ASSOCIATES, P.A.
Other - Org Name:VISION SPECIALTY ASSOC., P.A. #12
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:FURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:727-914-8616
Mailing Address - Street 1:4359 35TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-3717
Mailing Address - Country:US
Mailing Address - Phone:727-914-8616
Mailing Address - Fax:727-914-8610
Practice Address - Street 1:2637 E GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3216
Practice Address - Country:US
Practice Address - Phone:352-637-5180
Practice Address - Fax:352-423-1410
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VISION SPECIALTY ASSOCIATES, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-16
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620906800Medicaid