ELLIOTT STUPP (NPI# 1932131331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932131331 |
| Entity Type | Individual |
| Full Name | ELLIOTT STUPP |
| Credential | O.D. |
| Practice Address |
4171 S Tamiami Tr #34 Venice FL 34293-2932 |
| Mailing Address |
6248 Weymouth Dr Sarasota FL 34238-2763 |
| Practice Telephone | 9412236381 |
| Mailing Telephone | 9418896381 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2008-11-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPC 3404 | FL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 621028700 | 05 |
| Street Address |
4171 S TAMIAMI TR #34 |
| City | VENICE |
| State | FL |
| Zip Code | 34293-2932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700485729 | Wylan Bernitt | Dentist | 1215 Mercado Dr, Venice, FL 34293 | 2020-10-21 |
| 1841847720 | Joseph Matthew Adkins | Nurse Practitioner | 417 Lake of The Woods Dr, Venice, FL 34293 | 2019-08-24 |
| 1861047375 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 12165 Mercado Drive, Venice, FL 34293 | 2019-08-02 |
| 1265084107 | Safecare Transport, LLC | Non-emergency Medical Transport (VAN) | 18821 Bianchi Strret, Venice, FL 34293 | 2019-07-11 |
| 1932621869 | Mike Andry | Hearing Instrument Specialist | 4238 S. Tamiami Trail, Venice, FL 34293 | 2017-07-12 |
| 1659729861 | Danielle Gibellina | Occupational Therapy Assistant | 1507 S. Tuttle Ave, Magnolia Rehabilitation Center, Sarasota, FL 34293 | 2016-05-27 |
| 1891142501 | Jessica Kontoes | Behavioral Analyst | 19503 West Villages Parkway, A11, Venice, FL 34293 | 2016-05-23 |
| 1093161770 | Jillian Hinds | Behavioral Analyst | 19503 West Villages Pkwy, A11, Venice, FL 34293 | 2016-05-11 |
| 1003211509 | Roselle Joyce Beltran | Physical Therapist | 5865 Osprey Road, Venice, FL 34293 | 2014-10-27 |
| 1144649799 | Wendy Zinck-ladd | Case Manager/Care Coordinator | 19503 S.w.villages Parkway, Bldg. A, North Port, FL 34293 | 2014-04-10 |
| Find all providers in zip 34293 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740471705 | Eye Doctors Optical Outlets Pa | Optometrist | 4171 Tamiami Trl S, Suite 34, Venice, FL 34293-5111 | 2007-08-06 |
| 1659492502 | Eye Health & Vision Center Pa | Optometrist | 107 Shamrock Blvd, Venice, FL 34293-1630 | 2007-04-02 |
| 1225104136 | Michael Broder | Optometrist | 2165 Tamiami Trl S, Venice, FL 34293-5034 | 2006-11-24 |
| 1982709341 | John Braxton Lewis | Optometrist | 1236 Jacaranda Blvd, Venice, FL 34292 | 2006-09-13 |
| 1174578454 | Amy Suzanne Ragozzino | Optometrist | 4150 Tamiami Trl S, Venice, FL 34293-5130 | 2006-05-24 |
| 1457301921 | Melissa L Black | Optometrist | 1435 E Venice Ave, Suite 110, Venice, FL 34292-3074 | 2006-05-12 |
| 1366409112 | William J Cottone | Optometrist | 4171 Tamiami Trl S # 34, Venice, FL 34293-5111 | 2006-04-26 |
| 1982682423 | David Mark Rubin | Optometrist | 250 S. Tamiami Trl., Suite 103, Venice, FL 34285-2410 | 2006-01-05 |
| 1326037391 | James Richard Lenhart | Optometrist | 1360 E Venice Ave, Venice, FL 34285-9066 | 2005-10-20 |
| 1437154788 | Robert V Daddario | Optometrist | 1219 Jacaranda Blvd, Venice, FL 34292-4520 | 2005-06-14 |
| Find all providers in VENICE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.