Healthcare Provider Details

I. General information

NPI: 1710964077
Provider Name (Legal Business Name): JAMES A MUSE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 GULF TO BAY BLVD
CLEARWATER FL
33765-4413
US

IV. Provider business mailing address

2560 GULF TO BAY BLVD
CLEARWATER FL
33765-4413
US

V. Phone/Fax

Practice location:
  • Phone: 727-799-3772
  • Fax:
Mailing address:
  • Phone: 727-799-3772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2053DT
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number2053DT
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC2774
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: