=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689505166
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KUPLICKI EYECARE & OPTICAL, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2026
-----------------------------------------------------
Last Update Date | 05/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 519 DR MARTIN LUTHER KING JR ST N
-----------------------------------------------------
City | SAINT PETERSBURG
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-430-0624
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12428 WINDTREE BLVD
-----------------------------------------------------
City | SEMINOLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33772-2015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-430-0624
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/OPTOMETRIST
-----------------------------------------------------
Name | DR. DANE KUPLICKI
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 727-430-0624
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------