Provider Demographics
NPI:1275247330
Name:INNOVATIVE EYECARE, P.A.
Entity Type:Organization
Organization Name:INNOVATIVE EYECARE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SECRETARY TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPLUME
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:727-584-1893
Mailing Address - Street 1:800 E BAY DR STE G
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2553
Mailing Address - Country:US
Mailing Address - Phone:727-584-1893
Mailing Address - Fax:
Practice Address - Street 1:800 E BAY DR STE G
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-2553
Practice Address - Country:US
Practice Address - Phone:727-542-4432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty