Organization
VISION 21 MANAGED EYE CARE OF TAMPA BAY, INC
Active
Other names
Eye Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK DALTON (PRESIDENT)
(602) 912-9393
Entity
Organization
Contact information
Practice address
3033 N 44TH ST, STE 270, PHOENIX, AZ 85018-7226
(602) 912-9393
(602) 381-8994
Mailing address
3033 N 44TH ST, STE 270, PHOENIX, AZ 85018-7226
(602) 912-9393
(602) 381-8994
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
94171
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
469280
—
AZ
Enumeration date
12/10/2007
Last updated
12/10/2007
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