Organization
LIGHTHOUSE OF PINELLAS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL T MANN (PRESIDENT/CEO)
(727) 544-4433
Entity
Organization
Contact information
Practice address
6925 112TH CIR, LARGO, FL 33773-5200
(727) 544-4433
(727) 544-5511
Mailing address
6925 112TH CIR N, LARGO, FL 33773-5520
(727) 544-4433
(727) 544-5511
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
880145200
—
FL
05
—
880147900
—
FL
05
—
882356100
—
FL
Enumeration date
04/04/2006
Last updated
06/09/2016
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