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General NPI Number Information
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NPI Number | 1215414487
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Entity Type | Organization
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Legal Business Name | ISLAND OPTICS LLC
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Dates
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Enumeration Date | 07/20/2018
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Last Update Date | 02/07/2026
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Provider Practice Location Address
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Address Line | 5290 SEMINOLE BLVD STE F
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City | ST PETERSBURG
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State | FL
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Zip | 33708-3369
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Country | US
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Telephone | 727-800-4411
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Fax | 727-491-5075
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Provider Business Mailing Address
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Address Line | 5290 SEMINOLE BLVD STE F
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City | ST PETERSBURG
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State | FL
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Zip | 33708-3369
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Country | US
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Telephone | 727-800-4411
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Fax | 727-491-5075
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Authorized Official
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Title or Position | OWNER
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Name | REBEKAH ANNE KEMP
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Credential | OD
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Telephone | 727-800-4411
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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 | OPC4673
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License Number State | FL
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