| |
4505 E Hillsborough Ave, Suite B, Tampa, FL 33610-5200 | |
(813) 319-3904 | |
(813) 319-3997 |
Full Name | |
---|---|
Type | Facility |
Speciality | Technician/technologist - Optician |
Location | 4505 E Hillsborough Ave, Tampa, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427380120 | NPI | - | NPPES |
630366800 | Medicaid | FL |
Mailing Address | Practice Location Address |
---|---|
4505 E Hillsborough Ave, Suite B, Tampa, FL 33610-5200 Ph: (813) 319-3904 | 4505 E Hillsborough Ave, Suite B, Tampa, FL 33610-5200 Ph: (813) 319-3904 |