Provider Demographics
NPI:1508277948
Name:KREIFELS, KACIE MARIE (OD, MS)
Entity Type:Individual
Prefix:DR
First Name:KACIE
Middle Name:MARIE
Last Name:KREIFELS
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3979
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34230-3979
Mailing Address - Country:US
Mailing Address - Phone:727-535-2300
Mailing Address - Fax:727-535-2330
Practice Address - Street 1:1250 BELCHER RD S
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-5213
Practice Address - Country:US
Practice Address - Phone:727-535-2300
Practice Address - Fax:727-535-2330
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5020152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist