Organization Active NPI

TB Eyecare PA

Doing business as InnoVision

  • Optometrist
  • Largo, FL
National Provider Identifier
1538525266
Registry record updated Jan 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC1574 Issued in FL
Legal business name
TB EYECARE PA
Doing business as
InnoVision
Practice address
11650 131St St
Largo, FL 33774-4740
Phone
(727) 489-0500
Fax
(727) 489-0508
NPI assigned
Jan 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2016

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC1574 FL Primary

Addresses

Primary practice location

11650 131St St
Largo, FL 33774-4740

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

Locations

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

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": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1538525266",
    "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": "11650 131ST ST",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337744740",
            "telephone_number": "727-489-0500",
            "fax_number": "727-489-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TB EYECARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "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_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InnoVision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.