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Individual

DR. EDWARD JOHN WASLOSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1312 MANATEE AVE E, BRADENTON, FL 34208-1358
(941) 750-8797
(941) 799-2804
Mailing address
101 RIVERFRONT BLVD STE 710, BRADENTON, FL 34205-8812
(941) 776-4000
(941) 896-8480

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2214
FL
152W00000X
Optometrist
TA0943
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
279278800
MD
01
K769BH63
MEDICARE PTAN
MD
Enumeration date
06/23/2005
Last updated
10/26/2023
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