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Organization
ANTONIO PRADO MD PA
Active
Organization
ANTONIO PRADO MD PA
Active
Other names
Prado Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO PRADO MD (PRESIDENT CEO)
(813) 931-0500
Entity
Organization
Contact information
Practice address
7522 N HIMES AVE, TAMPA, FL 33614-3205
(813) 931-0500
Mailing address
7522 N HIMES AVE, TAMPA, FL 33614-3205
(813) 931-0500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
NULL
152W00000X
Optometrist
Primary
—
—
207W00000X
Ophthalmology Physician
ME64750
FL
332H00000X
Eyewear Supplier
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277042300
—
FL
01
—
99062
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
03/12/2007
Last updated
06/03/2020
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