Organization
FAMILY EYE CARE OF WESTSHORE P.L.
Active
Other names
Kenneth H. Green O.D.
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH H GREEN O.D. (MANAGER)
(813) 286-0433
Entity
Organization
Contact information
Practice address
4040 W KENNEDY BLVD, TAMPA, FL 33609-2750
(813) 286-0433
(813) 286-0498
Mailing address
4040 W KENNEDY BLVD, TAMPA, FL 33609-2750
(813) 286-0433
(813) 286-0498
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1473
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078017100
—
FL
Enumeration date
04/23/2009
Last updated
09/18/2009
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