# KKOPTOM LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548135106
- **Authorized official:** KHUSSBU SHAH OD (OPTOMETRIST)
- **Authorized official phone:** (727) 452-8399

## Contact information

- **Practice address:** 3108 N BOUNDARY BLVD, TAMPA, FL 33621-5050
- **Practice address phone:** (813) 840-1161
- **Mailing address:** 2511 N GRADY AVE UNIT 36, TAMPA, FL 33607-2689

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 10/06/2025
- **Last updated:** 12/08/2025