Provider Demographics
NPI:1710964077
Name:MUSE, JAMES A (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:MUSE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2560 GULF TO BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-4413
Mailing Address - Country:US
Mailing Address - Phone:727-799-3772
Mailing Address - Fax:
Practice Address - Street 1:2560 GULF TO BAY BLVD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-4413
Practice Address - Country:US
Practice Address - Phone:727-799-3772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2053DT152W00000X, 152WC0802X
FLOPC2774152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1649450115OtherPTAN
KY610866345OtherTAX IDENTIFICATION NUMBER
KYK276010OtherMEDICARE
FL203177656OtherTAX ID
FL5686290001OtherGROUP PTAN
FLU52510Medicare UPIN