Gregory L Cagle, O.D.

Individual provider Active NPI Optometrist · Seffner, FL

NPI 1174664205 · NPPES record last updated Apr 8, 2008

Key facts

NPI
1174664205
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
OPC1625 (FL)
Practice address
1016 W Dr Martin Luther King Jr Blvd
Seffner, FL 33584-4572
Phone
(813) 681-5151
NPI assigned
Feb 9, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC1625 FL Yes

Addresses

Primary practice location

1016 W Dr Martin Luther King Jr Blvd
Seffner, FL 33584-4572

Mailing address

1006 Mallow Way
Brandon, FL 33510-2955
Phone (813) 685-0590

Other providers in Seffner, FL

All providers in Seffner, FL · Optometrist in Florida

Sources for this page

Verify at the official NPI Registry.