Basic Information
| Provider Information | |||||||||
| NPI: | 1942518097 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAMES A PODSCHUN OD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1935 STATE ROAD 436 STE 1001 | ||||||||
| Address2: | |||||||||
| City: | WINTER PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327922244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076710960 | ||||||||
| FaxNumber: | 4076776696 | ||||||||
| Practice Location | |||||||||
| Address1: | 1935 STATE ROAD 436 STE 1001 | ||||||||
| Address2: | |||||||||
| City: | WINTER PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327922244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076710960 | ||||||||
| FaxNumber: | 4076776696 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2010 | ||||||||
| LastUpdateDate: | 02/05/2019 | ||||||||
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| AuthorizedOfficialLastName: | PODSCHUN | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4076710960 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | O.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2303 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.