# ANTONIO PRADO MD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cataract & Laser Institute of Brandon
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376840942
- **Authorized official:** DR. ANTONIO PRADO MD (PRESIDENT)
- **Authorized official phone:** (813) 931-0500

## Contact information

- **Practice address:** 7522 N HIMES AVE, TAMPA, FL 33614-3205
- **Practice address phone:** (813) 931-0500
- **Practice address fax:** (813) 936-2805
- **Mailing address:** 206 BUCKINGHAM PL, SUITE 102, BRANDON, FL 33511-4910
- **Mailing address phone:** (813) 653-2020
- **Mailing address fax:** (813) 653-2205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2011
- **Last updated:** 02/17/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 277042301 | — | FL |
| 01 | — | 99062A | BLUE CROSS BLUE SHIELD OF FLORIDA | FL |