James Revennaugh, OD | |
86 Ponce De Leon Blvd, Brooksville, FL 34601-2818 | |
(352) 796-2141 | |
Not Available |
Full Name | James Revennaugh |
---|---|
Gender | Male |
Speciality | Optometry |
Experience | 15 Years |
Location | 86 Ponce De Leon Blvd, Brooksville, Florida |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124251905 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPC 4450 (Florida) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Tampa Eye Clinic And Associates Pa | 8123928868 | 13 |
Provider Name | Tampa Eye Clinic And Associates Pa |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1013937861 PECOS PAC ID: 8123928868 Enrollment ID: O20040109000975 |
Mailing Address | Practice Location Address |
---|---|
James Revennaugh, OD 14073 Snow Memorial Hwy, Brooksville, FL 34601-4466 Ph: () - | James Revennaugh, OD 86 Ponce De Leon Blvd, Brooksville, FL 34601-2818 Ph: (352) 796-2141 |
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