Provider Demographics
NPI:1982697157
Name:ORLICK & KASPER , MDS, PA
Entity Type:Organization
Organization Name:ORLICK & KASPER , MDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/FRONT OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-525-3649
Mailing Address - Street 1:5800 49TH ST N
Mailing Address - Street 2:SUITE 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:SUITE 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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34691OtherBLUE SHIELD GROUP NUMBER
FL267330400Medicaid
FL34691OtherBLUE SHIELD GROUP NUMBER