Healthcare Provider Details

I. General information

NPI: 1710961487
Provider Name (Legal Business Name): JANIE A HO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 04/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 13TH ST SW
LARGO FL
33770-3127
US

IV. Provider business mailing address

148 13TH ST SW
LARGO FL
33770-3127
US

V. Phone/Fax

Practice location:
  • Phone: 727-581-8706
  • Fax: 727-588-2447
Mailing address:
  • Phone: 727-581-8706
  • Fax: 727-588-2447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME128782
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberME128782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: