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Individual

DR. JEE ME KANICKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
21517 VILLAGE LAKES SHOPPING CTR DR, LAND O LAKES, FL 34639-5101
(813) 949-0421
(813) 949-0351
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3907
FL
152WP0200X
Pediatric Optometrist
OPC 003907
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OPC 003907
STATE LICENSE
FL
Enumeration date
04/25/2006
Last updated
03/16/2022
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