Provider Demographics
NPI:1124295548
Name:DAVID NESS OD PA
Entity type:Organization
Organization Name:DAVID NESS OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:NESS
Authorized Official - Suffix:
Authorized Official - Credentials:OD PA
Authorized Official - Phone:352-625-0135
Mailing Address - Street 1:15936 E HIGHWAY 40
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34488-5144
Mailing Address - Country:US
Mailing Address - Phone:352-625-0135
Mailing Address - Fax:
Practice Address - Street 1:15936 E HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34488-5144
Practice Address - Country:US
Practice Address - Phone:352-625-0135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2612152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620294200Medicaid
FL20383AMedicare Oscar/Certification
FL1235820001Medicare NSC
FL620294200Medicaid