Organization
RIDGE EYE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JASMINE WORTHEN (CREDETNIALING SPECIALIST)
(727) 755-0693
Entity
Organization
Contact information
Practice address
7056 SKYWAY, PARADISE, CA 95969-3960
(530) 891-1900
(530) 895-1531
Mailing address
311 PARK PLACE BLVD, 5TH FLOOR, CLEARWATER, FL 33759-4904
(727) 755-0693
(727) 755-0679
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659502201
—
CA
Enumeration date
10/07/2015
Last updated
10/07/2015
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