| NPI | 1154537504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A SIBLEY Medical Director 727-895-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: FL ME30852) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 601418) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2011-10-20 |