Provider Demographics
NPI:1801069547
Name:SANTOS EYE LLC
Entity type:Organization
Organization Name:SANTOS EYE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRY DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTOS-TOMASSINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-932-2020
Mailing Address - Street 1:19455 SHUMARD OAK DR
Mailing Address - Street 2:STE 102
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-7257
Mailing Address - Country:US
Mailing Address - Phone:813-909-7281
Mailing Address - Fax:813-909-7681
Practice Address - Street 1:19455 SHUMARD OAK DR
Practice Address - Street 2:STE 102
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-7257
Practice Address - Country:US
Practice Address - Phone:813-909-7281
Practice Address - Fax:813-909-7681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4173261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAJ851Medicare PIN