Vita Park Eye Associates, Sc

NPI #1154418051 in Beaver Dam, Wisconsin

Provider Information

NPI Number: 1154418051
Entity Type: Organization
Organization Name: Vita Park Eye Associates, Sc
Primary Specialty: Ophthalmology
Enumeration Date: Oct 10, 2006
Last Updated: Apr 21, 2021

Practice Location

Address: 240 CORPORATE DRIVE
City: Beaver Dam
State: Wisconsin
ZIP Code: 53916
Phone: (920) 887-1151

Authorized Official

Name: THOMAS A CASTILLO, DO
Title: CORPORATE OFFICER
Phone: (920) 887-1151

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X
Ophthalmology	207W00000X	Primary

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