MEDICARE: ICARE TAMPA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1659047686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ICARE TAMPA, LLC

Provider Business Mailing Address
First Line	:	5537 SHELDON RD STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3167
Country	:	US
Telephone Number	:	813-806-0812
Fax Number	:

Provider Business Practice Location Address
First Line	:	5537 SHELDON RD STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3167
Country	:	US
Telephone Number	:	813-806-0812
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. NEIL PATEL
Credential	:	O.D.
Telephone Number	:	734-377-1188

Provider Enumeration Date	:	08/19/2021
Last Update Date	:	08/19/2021

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