Individual
GREGORY A LIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3115 W SWANN AVE, TAMPA, FL 33609-4617
(813) 492-2020
(813) 492-2099
Mailing address
403 VONDERBURG DR, BRANDON, FL 33511-5501
(813) 681-1122
(813) 689-1099
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 3354
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20965
BLUE CROSS BLUE SHIELD
FL
05
—
620771500
—
FL
01
—
7328183
AETNA
FL
Enumeration date
07/13/2005
Last updated
04/07/2025
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