Provider Demographics
NPI:1144538091
Name:RICHARD REED, OD, PA
Entity type:Organization
Organization Name:RICHARD REED, OD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:850-496-0935
Mailing Address - Street 1:8119 WHITE SANDS BLVD
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-7130
Mailing Address - Country:US
Mailing Address - Phone:850-496-0935
Mailing Address - Fax:850-316-4252
Practice Address - Street 1:8119 WHITE SANDS BLVD
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-7130
Practice Address - Country:US
Practice Address - Phone:850-496-0935
Practice Address - Fax:850-316-4252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 2923152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1285712737OtherNPI
FL20635Medicare PIN