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
—
—
207W00000X
Ophthalmology Physician
ME64750
FL
332H00000X
Eyewear Supplier
—
—
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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