# KEVIN SMITH OD AND ASSOCIATES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SOUTH TAMPA EYE SITE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023275468
- **Authorized official:** DR. KEVIN L. SMITH O.D. (PRESIDENT)
- **Authorized official phone:** (813) 207-8984

## Contact information

- **Practice address:** 4117 HENDERSON BLVD, TAMPA, FL 33629-5749
- **Practice address phone:** (813) 207-8984
- **Mailing address:** 4117 HENDERSON BLVD, TAMPA, FL 33629-5749
- **Mailing address phone:** (813) 207-8984

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 152WC0802X | Corneal and Contact Management Optometrist | — | NULL | Yes |
| 152WC0802X | Corneal and Contact Management Optometrist | — | — | Yes |
| 152WL0500X | Low Vision Rehabilitation Optometrist | — | NULL | — |
| 152WL0500X | Low Vision Rehabilitation Optometrist | — | — | — |
| 332H00000X | Eyewear Supplier | — | NULL | — |

## Other

- **Enumeration date:** 05/22/2008
- **Last updated:** 05/22/2008