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Individual

DR. JOHN ROBERT WALESBY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2510 W WATERS AVE, TAMPA, FL 33614-1833
(813) 915-0755
(813) 915-0704
Mailing address
2510 W WATERS AVE, TAMPA, FL 33614-1833
(813) 915-0755
(813) 915-0704

Taxonomy

Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
OPC 2811
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
084909000
FL
Enumeration date
08/08/2006
Last updated
01/26/2012
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