Provider Demographics
NPI:1720805237
Name:FAMILY VISION CENTER OF SARASOTA LLC
Entity type:Organization
Organization Name:FAMILY VISION CENTER OF SARASOTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:941-926-2020
Mailing Address - Street 1:3900 CLARK RD
Mailing Address - Street 2:SUITE P-1
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2379
Mailing Address - Country:US
Mailing Address - Phone:941-926-2020
Mailing Address - Fax:941-926-2021
Practice Address - Street 1:3900 CLARK RD
Practice Address - Street 2:SUITE P-1
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2379
Practice Address - Country:US
Practice Address - Phone:941-926-2020
Practice Address - Fax:941-926-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty