Provider Demographics
NPI:1932317211
Name:PAPARODIS, BRIAN DAVID (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:DAVID
Last Name:PAPARODIS
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7119 87TH LN E
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-1212
Mailing Address - Country:US
Mailing Address - Phone:941-723-0461
Mailing Address - Fax:
Practice Address - Street 1:3830 SUN CITY CENTER BLVD STE 105
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33573-6820
Practice Address - Country:US
Practice Address - Phone:813-634-6155
Practice Address - Fax:813-634-6236
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO3709156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician