Family Eye Care of Westshore P.L.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC1473 Issued in FL

Legal business name

FAMILY EYE CARE OF WESTSHORE P.L.

Practice address

4040 W Kennedy Blvd
Tampa, FL 33609-2750

Phone

(813) 286-0433

Fax

(813) 286-0498

NPI assigned

Apr 23, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth H Green, O.D.

Title

Manager

Phone

(813) 286-0433

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kenneth H. Green O.D. Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253232000000",
    "number": "1194969907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 W KENNEDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092750",
            "telephone_number": "813-286-0433",
            "fax_number": "813-286-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 W KENNEDY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092750",
            "telephone_number": "813-286-0433",
            "fax_number": "813-286-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY EYE CARE OF WESTSHORE P.L.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-23",
        "last_updated": "2009-09-18",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "813-286-0433",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078017100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenneth H. Green O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Optometrist in Tampa, FL
• Providers in Tampa, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.