Organization
PERFORMANCE EYECARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY JON BAUSBACK OD (PRESIDENT)
(219) 877-8635
Entity
Organization
Contact information
Practice address
2827 BON AIR AVE, SARASOTA, FL 34234-7345
(941) 361-9491
(904) 512-6636
Mailing address
2827 BON AIR AVE, SARASOTA, FL 34234-7345
(941) 361-9491
(904) 512-6636
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC5052
FL
Other
Enumeration date
04/24/2017
Last updated
04/02/2020
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