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General NPI Number Information
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NPI Number | 1952982886
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Entity Type | Organization
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Legal Business Name | OCULOFACIAL SURGERY AND COSMETIC LASER INSTITUTE LLC
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Dates
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Enumeration Date | 04/21/2021
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Last Update Date | 05/12/2021
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Provider Practice Location Address
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Address Line | 24420 STATE ROAD 54
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City | LUTZ
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State | FL
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Zip | 33559-7303
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Country | US
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Telephone | 813-303-0123
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Fax | 813-587-9861
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Provider Business Mailing Address
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Address Line | 24420 STATE ROAD 54
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City | LUTZ
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State | FL
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Zip | 33559-7303
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Country | US
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Telephone | 813-303-0123
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Fax | 813-587-9861
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Authorized Official
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Title or Position | OWNER / PROVIDER
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Name | DR. ROSHNI U RANJIT-REEVES
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Credential | MD
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Telephone | 813-303-0123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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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 | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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