Organization
EYE DOCTORS OPTICAL OUTLETS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT C. COPPOLA OD (PRESIDENT)
(954) 917-2337
Entity
Organization
Contact information
Practice address
4121 US HIGHWAY 98 N, #A-140, LAKELAND, FL 33809-3818
(863) 859-7100
Mailing address
5607 JOHNS RD, TAMPA, FL 33634-4317
(813) 885-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620937831
—
FL
Enumeration date
08/06/2007
Last updated
01/27/2025
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