Provider Demographics
NPI:1790812626
Name:JOHN L. MEYERS, OD PA
Entity Type:Organization
Organization Name:JOHN L. MEYERS, OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:727-845-5506
Mailing Address - Street 1:9408 US HIGHWAY 19
Mailing Address - Street 2:#504
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-4623
Mailing Address - Country:US
Mailing Address - Phone:727-845-5506
Mailing Address - Fax:727-842-6618
Practice Address - Street 1:9408 US HIGHWAY 19
Practice Address - Street 2:#504
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-4623
Practice Address - Country:US
Practice Address - Phone:727-845-5506
Practice Address - Fax:727-842-6618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL3195152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9223Medicare ID - Type Unspecified