Organization
EYE DOCTORS OPTICAL OUTLETS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANETTE ALLGOOD (CREDENTIALING)
(800) 353-5420
Entity
Organization
Contact information
Practice address
2469 W US HIGHWAY 90 STE A27, LAKE CITY, FL 32055-4738
(386) 515-8647
Mailing address
5607 JOHNS RD, TAMPA, FL 33634-4499
(813) 885-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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