Provider Demographics
NPI:1790189900
Name:DR. ANTHONY R. SZETELA AND ASSOCIATES, PA
Entity Type:Organization
Organization Name:DR. ANTHONY R. SZETELA AND ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:RAFAELE
Authorized Official - Last Name:SZETELA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:727-867-5128
Mailing Address - Street 1:3501 34TH ST S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33711-3820
Mailing Address - Country:US
Mailing Address - Phone:727-867-5128
Mailing Address - Fax:727-906-4026
Practice Address - Street 1:3501 34TH ST S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-3820
Practice Address - Country:US
Practice Address - Phone:727-867-5128
Practice Address - Fax:727-906-4026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3952152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL621014700Medicaid