| Organization Name: | FULL SPECTRUM FAMILY VISION CARE PA |
| NPI Number: | 1932372158 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATHER L. TRAPHEAGEN (PRESIDENT/OPTOMETRIST) |
| Mailing Address: | 1224 Del Prado Blvd S Unit A Cape Coral |
| State: | FL US |
| Postal Code: | 339903686 |
| Phone Number: | 2395733937 |
| Fax Number: | 2395730263 |
| NPI Enumeration Date: | 04/09/2008 |
| NPI Last Update Date: | 01/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | OPC3636 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |