Provider Demographics
NPI:1851336481
Name:WERNER, TRISHA DEE (OD)
Entity Type:Individual
Prefix:DR
First Name:TRISHA
Middle Name:DEE
Last Name:WERNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:TRISHA
Other - Middle Name:DEE
Other - Last Name:WERNER-DERBYSHIRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1360 E VENICE AVE
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-9066
Mailing Address - Country:US
Mailing Address - Phone:941-488-2020
Mailing Address - Fax:941-484-2200
Practice Address - Street 1:5394 FRUITVILLE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6401
Practice Address - Country:US
Practice Address - Phone:941-923-4594
Practice Address - Fax:941-923-4596
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2929152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20633FMedicare PIN
FLU51424Medicare UPIN
FLK6732Medicare PIN
FL1043249170Medicare PIN