Organization
COUNTRYWAY EYECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA RUSOFF O.D. (PRES)
(813) 925-3393
Entity
Organization
Contact information
Practice address
6911 PISTOL RANGE RD, TAMPA, FL 33635-6335
(813) 925-3393
(813) 925-3394
Mailing address
6911 PISTOL RANGE RD, TAMPA, FL 33635-6335
(813) 925-3393
(813) 925-3394
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP3810
FL
Other
Enumeration date
02/25/2014
Last updated
02/25/2014
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