NPIMap

Organization Active NPI

Fazio Eye Institute, PA

  • Optometrist
  • Tampa, FL
National Provider Identifier
1295911709
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAZIO EYE INSTITUTE, PA
Practice address
5208 E Fowler Ave
Suite B
Tampa, FL 33617-1906
Phone
(813) 988-1163
Fax
(813) 988-7563
NPI assigned
Jan 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Authorized official

Name
Dr. Diane E Kerris-Fazio, O.D.
Title
President
Phone
(813) 677-1424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

5208 E Fowler Ave
Suite B
Tampa, FL 33617-1906

Mailing address

5208 E Fowler Ave
Suite B
Tampa, FL 33617-1906
Phone (813) 988-1163

National Provider Directory

National Provider Directory

Locations

5208 E Fowler Ave
Ste B
Temple Terrace, FL 33617
Phone (813) 988-1163

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1295911709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5208 E FOWLER AVE",
            "address_2": "SUITE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336171906",
            "telephone_number": "813-988-1163",
            "fax_number": "813-988-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5208 E FOWLER AVE",
            "address_2": "SUITE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336171906",
            "telephone_number": "813-988-1163",
            "fax_number": "813-988-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAZIO EYE INSTITUTE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "KERRIS-FAZIO",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-677-1424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.