Organization
ANTONIO PRADO MD PA
Active
Other names
Cataract & Laser Institute of Brandon
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONIO PRADO MD (PRESIDENT)
(813) 931-0500
Entity
Organization
Contact information
Practice address
7522 N HIMES AVE, TAMPA, FL 33614-3205
(813) 931-0500
(813) 936-2805
Mailing address
206 BUCKINGHAM PL, SUITE 102, BRANDON, FL 33511-4910
(813) 653-2020
(813) 653-2205
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277042301
—
FL
01
—
99062A
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
Enumeration date
02/17/2011
Last updated
02/17/2011
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