| |
7522 N Himes Ave, Tampa, FL 33614-3205 | |
(813) 931-0500 | |
(813) 936-2805 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 7522 N Himes Ave, Tampa, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376840942 | NPI | - | NPPES |
277042301 | Medicaid | FL | |
99062A | Other | FL | BLUE CROSS BLUE SHIELD OF FLORIDA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
206 Buckingham Pl, Suite 102, Brandon, FL 33511-4910 Ph: (813) 653-2020 | 7522 N Himes Ave, Tampa, FL 33614-3205 Ph: (813) 931-0500 |