NPIMap

Organization Active NPI

TB Eye Care PA

  • Optometrist
  • St Petersburg, FL
National Provider Identifier
1497805535
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TB EYE CARE PA
Practice address
1450 66TH St N
St Petersburg, FL 33710-5504
Phone
(727) 381-3937
Fax
(727) 345-6956
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Authorized official

Name
Dr. Theodore N Gillette, O.D.NPI 1851392666
Title
President
Phone
(727) 489-0500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1450 66TH St N
St Petersburg, FL 33710-5504

Mailing address

11650 131St St
Largo, FL 33774-4740
Phone (727) 489-0500

Other names 1

  • InnoVision Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Innovision5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1450 66th St N
St Petersburg, FL 33710
Phone (727) 381-3937

Practitioners & affiliated clinicians

Practitioners 1

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": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1497805535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 131ST ST",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337744740",
            "telephone_number": "727-489-0500",
            "fax_number": "727-489-0508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 66TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105504",
            "telephone_number": "727-381-3937",
            "fax_number": "727-345-6956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TB EYE CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "GILLETTE",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-489-0500",
        "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": [
        {
            "organization_name": "InnoVision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.