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General NPI Number Information
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NPI Number | 1245668201
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Entity Type | Organization
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Legal Business Name | H. KIRK FALLIN, O.D. & ASSOCIATES, P.A.,
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 8201 S TAMIAMI TRL UNIT 51 SUITE 51
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City | SARASOTA
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State | FL
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Zip | 34238-2950
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Country | US
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Telephone | 941-923-4111
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Fax | 941-926-2981
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Provider Business Mailing Address
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Address Line | 8201 S TAMIAMI TRL UNIT 51 SUITE 51
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City | SARASOTA
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State | FL
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Zip | 34238-2950
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Country | US
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Telephone | 941-923-4111
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Fax | 941-926-2981
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Authorized Official
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Title or Position | CEO
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Name | DR. HERBERT KIRK FALLIN III
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Credential | O.D.
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Telephone | 941-923-4111
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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 | OPC3228
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License Number State | FL
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