Provider Demographics
NPI:1669743837
Name:MEDICAL EYE ASSOCIATES OF TAMPA,P.A.
Entity type:Organization
Organization Name:MEDICAL EYE ASSOCIATES OF TAMPA,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH CARE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-354-5808
Mailing Address - Street 1:7840 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4301
Mailing Address - Country:US
Mailing Address - Phone:513-354-5808
Mailing Address - Fax:513-354-5774
Practice Address - Street 1:2202 N WEST SHORE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5747
Practice Address - Country:US
Practice Address - Phone:813-289-2648
Practice Address - Fax:813-414-0073
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LCAVISION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty