Healthcare Provider Details

I. General information

NPI: 1104850122
Provider Name (Legal Business Name): WEST FLORIDA OPHTHALMOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 CURLEW RD
OLDSMAR FL
34677-2606
US

IV. Provider business mailing address

3155 CURLEW RD
OLDSMAR FL
34677-2606
US

V. Phone/Fax

Practice location:
  • Phone: 727-216-2020
  • Fax: 727-216-1173
Mailing address:
  • Phone: 727-216-2020
  • Fax: 727-216-1173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LAURA T MULLER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 727-216-2020