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General NPI Number Information
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NPI Number | 1073906194
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Entity Type | Organization
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Legal Business Name | SHAMIKA L HONEYBLUE OD PA
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Dates
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Enumeration Date | 03/13/2015
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Last Update Date | 03/13/2015
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Provider Practice Location Address
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Address Line | 7211 US HIGHWAY 19 N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-4613
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Country | US
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Telephone | 727-521-2020
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Fax | 727-521-6762
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Provider Business Mailing Address
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Address Line | 4601 GRAYVIEW CT APT 209C
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City | TAMPA
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State | FL
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Zip | 33609-5000
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Country | US
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Telephone | 727-521-2020
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Fax | 727-521-6762
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Authorized Official
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Title or Position | OD/OWNER
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Name | SHAMIKA LYNETTE HONEYBLUE
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Credential | OD
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Telephone | 727-521-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4445
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License Number State | FL
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