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General NPI Number Information
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NPI Number | 1639403058
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Entity Type | Individual
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Provider Name | KELLY KRISTINE CHAMBERS O.D.
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Gender | Female
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 9912 W LINEBAUGH AVE
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City | TAMPA
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State | FL
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Zip | 33626-1858
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Country | US
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Telephone | 813-792-0637
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Fax | 813-792-0657
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Provider Business Mailing Address
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Address Line | 9912 W LINEBAUGH AVE
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City | TAMPA
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State | FL
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Zip | 33626-1858
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Country | US
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Telephone | 813-792-0637
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Fax | 813-792-0657
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPT002557
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | I3-0001346
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4980
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License Number State | FL
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