Provider Demographics
NPI:1790488013
Name:THE EYE PHYSICIANS OF PINELLAS, PA
Entity Type:Organization
Organization Name:THE EYE PHYSICIANS OF PINELLAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PRAVOOT
Authorized Official - Last Name:GIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-909-0633
Mailing Address - Street 1:15933 CLAYTON RD STE 210
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2172
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:
Practice Address - Street 1:4708 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2165
Practice Address - Country:US
Practice Address - Phone:863-644-6455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE EYE PHYSICIANS OF PINELLAS, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies