Provider Demographics
NPI:1457839847
Name:SINGLETON, ANDRE (LDO)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4359 35TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-3717
Mailing Address - Country:US
Mailing Address - Phone:727-914-8615
Mailing Address - Fax:727-914-8610
Practice Address - Street 1:35170 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1929
Practice Address - Country:US
Practice Address - Phone:727-789-5333
Practice Address - Fax:727-223-9027
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO6854156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician