Organization
GEORGE L. VAZOULAS, O.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE VAZOULAS (OWNER)
(352) 817-2625
Entity
Organization
Contact information
Practice address
3100 SW COLLEGE RD, OCALA, FL 34474-4419
(352) 237-7001
Mailing address
3100 SW COLLEGE RD, OCALA, FL 34474-4419
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 2634
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07984400
—
FL
01
—
BD727
PTAN
—
Enumeration date
01/08/2009
Last updated
07/17/2009
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