Healthcare Provider Details
I. General information
NPI: 1437042629
Provider Name (Legal Business Name): RETINA CENTER TAMPA BAY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/29/2025
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7515 STATE ROAD 52 STE 106
HUDSON FL
34667-6757
US
IV. Provider business mailing address
PO BOX 1155
DUNEDIN FL
34697-1155
US
V. Phone/Fax
- Phone: 727-877-7710
- Fax: 727-877-7709
- Phone: 727-877-7710
- Fax: 727-877-7709
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207WX0107X |
| Taxonomy | Retina Specialist (Ophthalmology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANA
M
DUPREE
Title or Position: OWNER
Credential: MD
Phone: 727-877-7710