Healthcare Provider Details

I. General information

NPI: 1326989906
Provider Name (Legal Business Name): SOPHIA LEIGH BORIS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 N HOWARD AVE STE 100
TAMPA FL
33606-1213
US

IV. Provider business mailing address

4344 DAIRY CT
BRADENTON FL
34211-1362
US

V. Phone/Fax

Practice location:
  • Phone: 813-253-2727
  • Fax:
Mailing address:
  • Phone: 234-380-7298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6987
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: