Provider Demographics
NPI:1366092595
Name:STARVISION OPTOMETRY PLLC
Entity type:Organization
Organization Name:STARVISION OPTOMETRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSTANKOVSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-742-0523
Mailing Address - Street 1:6700 N DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-6304
Mailing Address - Country:US
Mailing Address - Phone:219-742-0523
Mailing Address - Fax:
Practice Address - Street 1:5100 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8735
Practice Address - Country:US
Practice Address - Phone:850-477-7647
Practice Address - Fax:850-476-9836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty