Provider Demographics
NPI:1285827170
Name:JOHN F ALTENBURG, MD, PA
Entity Type:Organization
Organization Name:JOHN F ALTENBURG, MD, PA
Other - Org Name:TAMPA CATARACT AND EYE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALTENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-877-7265
Mailing Address - Street 1:4600 N HABANA AVE
Mailing Address - Street 2:SUITE #7
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7166
Mailing Address - Country:US
Mailing Address - Phone:813-877-7265
Mailing Address - Fax:813-878-0587
Practice Address - Street 1:4600 N HABANA AVE
Practice Address - Street 2:SUITE #7
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7166
Practice Address - Country:US
Practice Address - Phone:813-877-7265
Practice Address - Fax:813-878-0587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0035287261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
30300AMedicare PIN
FLD85518Medicare UPIN