Provider Demographics
NPI:1912907122
Name:KASPER, JEFFREY I (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:I
Last Name:KASPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5800 49TH ST N
Mailing Address - Street 2:S-109
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-2146
Mailing Address - Country:US
Mailing Address - Phone:727-522-1115
Mailing Address - Fax:727-522-0018
Practice Address - Street 1:5800 49TH ST N
Practice Address - Street 2:S-109
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2146
Practice Address - Country:US
Practice Address - Phone:727-522-1115
Practice Address - Fax:727-522-0018
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0084151207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263559300Medicaid
FLE7039XMedicare PIN
FLE7039YMedicare PIN
FLG85364Medicare UPIN
FL263559300Medicaid
FLE7039ZMedicare PIN