NPIMap

Organization Active NPI

Provision Laser Eye Center PA

  • Durable Medical Equipment & Medical Supplies
  • Englewood, FL
National Provider Identifier
1639217540
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PROVISION LASER EYE CENTER PA
Practice address
473 S Indiana Ave
Englewood, FL 34223-3736
Phone
(941) 475-8532
Fax
(941) 460-0642
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Scott P Durrett, M.D.NPI 1558366898
Title
Owner
Phone
(941) 493-0311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X FL Primary

Addresses

Primary practice location

473 S Indiana Ave
Englewood, FL 34223-3736

Mailing address

1191 Jacaranda Blvd
Venice, FL 34292-4518
Phone (941) 493-0311

Other names 1

  • Provision Eyewear Doing business as

National Provider Directory

National Provider Directory

Locations

473 S Indiana Ave
Englewood, FL 34223
Phone (941) 475-8532

73 S Indiana Ave
Englewood, FL 34223
Phone (941) 475-8532

501 S Indiana Ave
Englewood, FL 34223
Phone (941) 460-6174

1191 Jacaranda Blvd
Venice, FL 34292
Phone (941) 488-2030

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1639217540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 JACARANDA BLVD",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342924518",
            "telephone_number": "941-493-0311",
            "fax_number": "941-492-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 S INDIANA AVE",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342233736",
            "telephone_number": "941-475-8532",
            "fax_number": "941-460-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION LASER EYE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "DURRETT",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-493-0311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provision Eyewear",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Englewood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.