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Organization
SUN COAST EYE CARE INC
Active
Organization
SUN COAST EYE CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY LOU SMITH B.S., O.D. (SECRETARY TREASURER)
(727) 216-6214
Entity
Organization
Contact information
Practice address
2451 MCMULLEN BOOTH RD, SUITE 221, CLEARWATER, FL 33759
(727) 216-6214
(727) 431-0363
Mailing address
2451 MCMULLEN BOOTH RD, SUITE 221, CLEARWATER, FL 33759
(727) 216-6214
(727) 431-0363
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2660
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620094000
—
FL
01
—
K0046
MEDICARE GROUP NUMBER
—
Enumeration date
09/26/2007
Last updated
12/29/2014
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