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Organization
PASADENA EYE CENTER, LLC
Active
Organization
PASADENA EYE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID E. HALL M.D. (MEDICAL DIRECTOR)
(727) 343-3004
Entity
Organization
Contact information
Practice address
6950 CENTRAL AVE, ST PETERSBURG, FL 33707-1210
(727) 343-3004
(727) 343-9521
Mailing address
6950 CENTRAL AVE, ST PETERSBURG, FL 33707-1210
(727) 343-3004
(727) 343-9521
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33343
BLUE CROSS/BLUE SHIELD
FL
01
—
5451200001
CIGNA GOVERNMENT SERVICES
FL
01
—
DD6403
RAILROAD MEDICARE
FL
Enumeration date
07/12/2006
Last updated
05/16/2013
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