Provider Demographics
NPI:1356924245
Name:CORINNE SPEIGHT, O.D., LLC
Entity type:Organization
Organization Name:CORINNE SPEIGHT, O.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:813-832-3800
Mailing Address - Street 1:3201 S DALE MABRY HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-7800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3201 S DALE MABRY HWY STE 105
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-7800
Practice Address - Country:US
Practice Address - Phone:813-832-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty