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General NPI Number Information
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NPI Number | 1013937861
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Entity Type | Organization
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Legal Business Name | TAMPA EYE CLINIC AND ASSOCIATES PA
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 3000 W DR MARTIN LUTHER KING JR BLVD
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City | TAMPA
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State | FL
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Zip | 33607-6308
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Country | US
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Telephone | 813-877-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 W DR MARTIN LUTHER KING JR BLVD
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City | TAMPA
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State | FL
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Zip | 33607-6308
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Country | US
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Telephone | 813-877-2020
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOHN B. RICHARDSON
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Credential |
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Telephone | 813-877-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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