# ASSOCIATED OPTOMETRISTS OF OVERHOLSER & OVERHOLSER OD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063573574
- **Authorized official:** DR. TERRIE JO OVERHOLSER O.D. (OWNER/DOCTOR)
- **Authorized official phone:** (352) 875-1173

## Contact information

- **Practice address:** 17961 S HIGHWAY 441, SUMMERFIELD, FL 34491
- **Practice address phone:** (352) 307-4435
- **Practice address fax:** (352) 307-4437
- **Mailing address:** 21455 NW 39TH CT, MICANOPY, FL 32667
- **Mailing address phone:** (352) 875-1173
- **Mailing address fax:** (352) 237-9479

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 12/12/2006
- **Last updated:** 09/29/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 45326 | BCBS OF FL | FL |