Provider Demographics
NPI:1922654029
Name:PRECISION OPTICAL PA
Entity Type:Organization
Organization Name:PRECISION OPTICAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:STROUD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:727-937-6551
Mailing Address - Street 1:41272 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-5106
Mailing Address - Country:US
Mailing Address - Phone:727-937-6551
Mailing Address - Fax:727-942-7200
Practice Address - Street 1:41272 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-5106
Practice Address - Country:US
Practice Address - Phone:727-937-6551
Practice Address - Fax:727-942-7200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty