Individual
ERIC A FAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
13904 N DALE MABRY HWY, SUITE 200, TAMPA, FL 33618-2446
(813) 908-2020
(813) 908-2133
Mailing address
13904 N DALE MABRY HWY, SUITE 200, TAMPA, FL 33618-2446
(813) 908-2020
(813) 908-2133
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3003
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006636600
—
FL
Enumeration date
09/19/2005
Last updated
03/06/2013
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