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General NPI Number Information
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NPI Number | 1235787441
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Entity Type | Organization
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Legal Business Name | APEX VISION, INC
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Dates
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Enumeration Date | 08/30/2019
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 15302 N NEBRASKA AVE
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City | TAMPA
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State | FL
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Zip | 33613-1448
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Country | US
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Telephone | 813-371-9020
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Fax |
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Provider Business Mailing Address
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Address Line | 3249 STONEGATE FALLS DR
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City | LAND O LAKES
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State | FL
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Zip | 34638-6195
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Country | US
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Telephone | 813-495-8883
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. LUC E KANICKY
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Credential | OD
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Telephone | 813-495-5116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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