| South Tampa Eye Site | |
|
4117 Henderson Blvd, Tampa, FL 33629-5749 | |
| (813) 207-8984 | |
| (813) 207-8954 |
| Full Name | South Tampa Eye Site |
|---|---|
| Type | Facility |
| Speciality | Optometrist - Corneal And Contact Management |
| Location | 4117 Henderson Blvd, Tampa, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487844536 | NPI | - | NPPES |
| 11221087 | Other | FL | CAQH |
| 620814201 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152WC0802X | Optometrist - Corneal And Contact Management | OPC3456 (Florida) | Primary |
| 332H00000X | Eyewear Supplier | OPC 3456 (Florida) | Secondary |
| Provider Name | Kevin L Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518945179 PECOS PAC ID: 4284531989 Enrollment ID: I20031218000800 |
| Mailing Address | Practice Location Address |
|---|---|
| South Tampa Eye Site 4117 Henderson Blvd, Tampa, FL 33629-5749 Ph: (813) 207-8984 | South Tampa Eye Site 4117 Henderson Blvd, Tampa, FL 33629-5749 Ph: (813) 207-8984 |
Dr. Alvina Qureshi, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 2201 E Fowler Ave Ste B, Tampa, FL 33612 Phone: 813-972-1573 Fax: 813-632-0563 | |
Dr. Carlos Naguib, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3031 W Spruce St, Tampa, FL 33607 Phone: 954-706-2945 | |
Dr. William Henry Stephen, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 5885 Gunn Hwy, Tampa, FL 33625 Phone: 813-908-0100 Fax: 813-908-0099 | |
Dr. Barry A Aronson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 11402 Georgetown Cir, Tampa, FL 33635 Phone: 813-383-6977 Fax: 413-793-8724 | |
Dr. Linhan T. Truong, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2201 E. Fowler Ave., Ste. B, Tampa, FL 33612 Phone: 813-972-1573 Fax: 813-972-3081 | |
Erin Swichkow Cooper, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 13602 N 46th St, Tampa, FL 33613 Phone: 813-972-4444 Fax: 813-979-1600 | |
South Tampa Eye Site Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4117 Henderson Blvd, Tampa, FL 33629 Phone: 813-207-8984 |