Organization
FAMILY VISION SERVICES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRIS MATSUKADO O.D. (PRESIDENT)
(813) 340-1025
Entity
Organization
Contact information
Practice address
301 EAGLE RIDGE DR, LAKE WALES, FL 33859-4751
(863) 679-2068
Mailing address
12718 BRAMFIELD DR, RIVERVIEW, FL 33569-7776
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP0482
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP0482
EYEMED
FL
Enumeration date
05/14/2007
Last updated
08/22/2020
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