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General NPI Number Information
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NPI Number | 1740416049
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Entity Type | Organization
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Legal Business Name | THE EYE CARE PROFESSIONALS OF TAMPA BAY
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Dates
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Enumeration Date | 06/02/2009
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Last Update Date | 09/17/2013
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Provider Practice Location Address
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Address Line | 24412 STATE ROAD 54
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City | LUTZ
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State | FL
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Zip | 33559
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Country | US
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Telephone | 813-949-7274
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Fax | 813-949-2481
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Provider Business Mailing Address
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Address Line | 24412 STATE ROAD 54
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City | LUTZ
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State | FL
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Zip | 33559
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Country | US
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Telephone | 813-949-7274
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Fax | 813-949-2481
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. DAVID FRANKLIN SCAMARD
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Credential | O.D.
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Telephone | 813-949-7274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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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 | 3394
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License Number State | FL
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