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Organization

TAMPA BAY OPHTHALMIC PLASTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENDRA DENISE DEANGELIS MD (OWNER)
(727) 285-8006
Entity
Organization

Contact information

Practice address
28050 US HIGHWAY 19 N STE 402, CLEARWATER, FL 33761-2629
(727) 285-8006
(727) 216-6560
Mailing address
28050 US HIGHWAY 19 N STE 402, CLEARWATER, FL 33761-2629
(727) 285-8006
(727) 216-6560

Taxonomy

Speciality
Code
Description
License number
State
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1380996
CAQH
FL
Enumeration date
06/02/2020
Last updated
12/16/2025
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