# ANTONIO PRADO MD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prado Vision Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376675454
- **Authorized official:** ANTONIO PRADO MD (PRESIDENT CEO)
- **Authorized official phone:** (813) 931-0500

## Contact information

- **Practice address:** 7522 N HIMES AVE, TAMPA, FL 33614-3205
- **Practice address phone:** (813) 931-0500
- **Mailing address:** 7522 N HIMES AVE, TAMPA, FL 33614-3205
- **Mailing address phone:** (813) 931-0500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |
| 207W00000X | Ophthalmology Physician | ME64750 | FL | — |
| 332H00000X | Eyewear Supplier | — | NULL | — |

## Other

- **Enumeration date:** 03/12/2007
- **Last updated:** 06/03/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 277042300 | — | FL |
| 01 | — | 99062 | BLUE CROSS BLUE SHIELD FL | FL |